Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications.
BACKGROUND
Chronic exertional compartment syndrome (CECS) is a common injury in young athletes, causing pain in the involved leg compartment during strenuous exercise. The gold standard treatment is fasciotomy, but most of the reports on its effectiveness include relatively small cohorts and relatively short follow-up periods. This study reports the long-term results of a large cohort of young athletes who underwent single-incision fasciotomy for CECS.


METHODS
This a retrospective case-series study. All patients treated by fasciotomies performed for CECS between 2007 and 2011, in a tertiary medical institution. CECS was diagnosed following history taking and clinical evaluation, and confirmed by compartment pressure measurements. Ninety-five legs that underwent single-incision subcutaneous fasciotomy were included. Data on the numerical analog scale (NAS), Tegner activity score, and quality-of-life (QOL) as measured via the short form-12 (SF-12) were retrieved from all patients preoperatively and at the end of follow-up.


RESULTS
The average time to diagnosis was 22 months and the mean follow-up was 50.1 months. Sixty-three legs underwent anterior compartment fasciotomy (an additional 30 legs also underwent lateral compartment release), and two legs underwent lateral and peroneal compartment releases. The average change in Tegner score was an improvement of 14.6 points. Similarly, the patients reported a significant improvement in the SF-12 and NAS scores. Satisfaction rates were high (average 75.5 %). The main complications were wound infection (2 patients) and nerve injuries (4 patients). Eight patients had recurrence.


CONCLUSIONS
Single-incision fasciotomy leads to long-term improvement in the activity level and QOL of patients with CECS.
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. mt.drexler@gmail.com.
Michael
M
Drexler
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
T Frenkel
TF
Rutenberg
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
N
N
Rozen
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Y
Y
Warschawski
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
E
E
Rath
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
O
O
Chechik
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
G
G
Rachevsky
Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
G
G
Morag
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003161:Compartment Syndromes / Q000209:etiology / Q000601:surgery*; D000071938:Fasciotomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D065466:Lysholm Knee Score; D008297:Male; D010146:Pain / Q000209:etiology; D005082:Physical Exertion; D011183:Postoperative Complications; D011312:Pressure; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
Chronic exertional compartment syndrome (CECS); Fasciotomy; Leg pain; Sports medicine