title: Feasibility and Safety of an Operative Tool for Anterior Chronic Exertional Compartment Syndrome Treatment.
abstract: BACKGROUND
  Operative management of chronic exertional compartment syndrome of the tibialis anterior muscle compartment (ant-CECS) usually involves the use of a fasciotome. Collateral tissue damage such as hematoma and nerve damage may occur during the procedure. The current report assessed the feasibility and safety of an alternative tool for the operative management of ant-CECS.
  
  
  METHODS
  The system had a speculum-like hollow tube that was inserted via a 2-cm skin incision and allowed for the protected advancement of a fasciotome. The device was tested in patients with bilateral ant-CECS. Symptoms were prospectively scored before and after surgery using a 5-category verbal rating scale (VRS). Fourteen patients (age 26 ± 10 years) were analyzed. Complications and operative efficacy were determined using physical examination and questionnaires after 21 (range = 16-25) months.
  
  
  RESULTS
  Technical operative success rate was 100% (28/28 legs). Operation time was 10 ± 2 minutes per leg (range = 6-14). Perioperative complications were not observed. One superficial wound infection was treated nonoperatively. Significant reductions in pain (-2.2 ± 1.1 on 5-point VRS, P < .001), tightness (-1.9 ± 1.6, P = .01), cramps (-1.4 ± 1.6, P = .009), muscle weakness (-1.6 ± 1.2, P < .001), and altered sensibility (-1.3 ± 1.4, P = .005) were registered 21 months postoperatively.
  
  
  CONCLUSIONS
  This fasciotome was simple to use and allowed for a safe fasciotomy in patients with leg ant-CECS. A randomized controlled trial comparing the present device with a widely used fasciotome was under way at the time of writing of this study.
authors.affiliation: Department of Surgery, Máxima Medical Center, Veldhoven, the Netherlands j.debruijn@mmc.nl.
authors.forename: Johan A
authors.initials: JA
authors.lastname: de Bruijn
authors.affiliation: Department of Surgery, Máxima Medical Center, Veldhoven, the Netherlands.
authors.forename: Aniek P M
authors.initials: AP
authors.lastname: van Zantvoort
authors.affiliation: Department of Surgery, Máxima Medical Center, Veldhoven, the Netherlands.
authors.forename: Michiel B
authors.initials: MB
authors.lastname: Winkes
authors.affiliation: Department of Surgery, Máxima Medical Center, Veldhoven, the Netherlands.
authors.forename: Leo
authors.initials: L
authors.lastname: Raaymakers
authors.affiliation: Department of Sports Medicine, Máxima Medical Center, Veldhoven, the Netherlands.
authors.forename: Marike
authors.initials: M
authors.lastname: van der Cruijsen-Raaijmakers
authors.affiliation: Department of Sports Medicine, Máxima Medical Center, Veldhoven, the Netherlands.
authors.forename: Adwin R
authors.initials: AR
authors.lastname: Hoogeveen
authors.affiliation: Department of Surgery, Máxima Medical Center, Veldhoven, the Netherlands CARIM Research School, Maastricht University, Maastricht, the Netherlands.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Scheltinga
mesh_terms: D000293:Adolescent; D000328:Adult; D003161:Compartment Syndromes / Q000601:surgery*; D004867:Equipment Design; D000071938:Fasciotomy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D061214:Patient Safety; D017060:Patient Satisfaction; D005082:Physical Exertion; D000068958:Return to Sport; D013525:Surgical Instruments; D055815:Young Adult
keywords: fasciotomy; leg pain; sports medicine