title: Assessing outcomes in individuals undergoing fasciotomy for chronic exertional compartment syndrome of the leg.
abstract: OBJECTIVE
  The purposes of this study were to evaluate patient-reported outcomes after fasciotomy of the leg for chronic exertional compartment syndrome (CECS) and to determine the rate at which revision surgery was required and the prognostic value of intracompartmental pressure (ICP) testing.
  
  
  METHODS
  This was a retrospective consecutive case series of patients with CECS who underwent preoperative ICP testing and surgical fasciotomy for treatment of CECS of the leg between September 2001 and January 2012.
  
  
  RESULTS
  Of 69 eligible patients, 46 were evaluated at a mean follow-up time of 54.9 months (range, 3.9 to 127.3 months). Forty-two patients met the Pedowitz criteria for CECS diagnosis. Mean score on the Lower Extremity Functional Scale (LEFS) was 70.4 (standard deviation [SD] ± 11.2) at follow-up and 72.3 (SD ± 11.2) at the patient-perceived time of best outcome. Best outcome was reported at a mean time of 14.3 months (range, 0.5 to 84 months). Five of 46 (11%) patients required a revision fasciotomy. Thirty-six of 46 (78%) patients reported being either satisfied (n = 14) or very satisfied (n = 22) at follow-up. The Pedowitz criteria were highly sensitive (97%) but not specific (10%) and had a positive predictive value (PPV) of 79%.
  
  
  CONCLUSIONS
  Functional outcomes after fasciotomy for CECS were favorable. ICP testing was shown to be sensitive but not specific. Revision surgery was required for 5 of the 46 patients (11%). Patient satisfaction rates, return to sport, return to preoperative activity levels, and LEFS scores were all high. This case series confirms that fasciotomy is a safe and effective surgical treatment for CECS.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Division of Orthopaedic Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. Electronic address: pasicnick@gmail.com.
authors.forename: Nick
authors.initials: N
authors.lastname: Pasic
authors.affiliation: Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Dianne
authors.initials: D
authors.lastname: Bryant
authors.affiliation: Division of Orthopaedic Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Willits
authors.affiliation: Division of Orthopaedic Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Whitehead
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult