title: Single minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg.
abstract: BACKGROUND
  Chronic exertional compartment syndrome (CECS) involves a painful increase in compartment pressure caused by exercise and relieved by rest, common in athletes. The most common site for CECS in the lower limbs is the anterior leg compartment. The aim of this study is to evaluate the outcomes of a single minimal incision fasciotomy in athletes and their capability to return to high level sport activity.
  
  
  METHODS
  The study reports mid-term results in a series of 18 consecutive athletes with chronic exertional compartment syndrome of the leg who had undergone minimally invasive fasciotomy. Between 2000 and 2007, we prospectively enrolled 18 consecutive athletes (12 males and six females, median age 27 years) with unilateral or bilateral chronic exertional compartment syndrome undergoing unilateral or bilateral minimally invasive fasciotomy. Clinical outcomes were assessed with Short-Form Health Survey-36 (SF-36) and European Quality of Life-5 Dimension (EQ-5D) scale. The ability to participate in sport before and after surgery and the time to return to training (RTT) and to sport (RTS) were recorded.
  
  
  RESULTS
  The median follow-up after surgery was 36 months. Both questionnaires showed a statistically significant improvement (P < 0.0001) after surgery. At the time of the latest follow-up, 17 of 18 patients (94 %) had returned to pre-injury or higher levels of sport. Only one patient (6 %) returned to sport at lower levels than those of pre-injury status. The median time to return to training and to return to sport was 8 and 13 weeks, respectively. No severe complications or recurrence of the symptoms were recorded.
  
  
  CONCLUSIONS
  Minimally invasive fasciotomy is effective and safe for athletes suffering from unilateral or bilateral chronic exertional compartment syndrome of the anterior and lateral compartments of the leg with good results in the mid-term.
authors.affiliation: Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy. n.maffulli@qmul.ac.uk.|Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England. n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Alvaro del Portillo, 200, 00128, Trigoria, Rome, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Loppini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Alvaro del Portillo, 200, 00128, Trigoria, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Spiezia
authors.affiliation: Department of Public Health, Section of Orthopaedic and Trauma Surgery, University of Naples "Federico II", School of Medicine and Surgery, Naples, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: D'Addona
authors.affiliation: Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England.
authors.forename: Gayle D
authors.initials: GD
authors.lastname: Maffulli
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003161:Compartment Syndromes / Q000601:surgery*; D015444:Exercise / Q000502:physiology; D000071938:Fasciotomy / Q000379:methods*; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D000068958:Return to Sport / Q000502:physiology; D013177:Sports / Q000502:physiology; D016896:Treatment Outcome
keywords: Compartment syndrome; Exertional; Fasciotomy; Leg; Minimal invasive