Chronic Compartment Syndrome of the Flexor Muscles in the Forearm: A Case Report

Allen, M.J.; Barnes, M.R.

doi:10.1016/0266-7681(89)90014-4

Cited by 44 publications

(28 citation statements)

References 6 publications

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“…There are only a few case reports of upper extremity ECS published in the literature, and most are of a chronic nature. [12][13][14][15] While measuring the compartment pressure in cases of CECS, Hutchinson et al found that exertion-related fiber swelling and increased intracompartmental blood volume or increased osmotic pressure associated with myofiber damage may cause compartment pressure to rise. 16 Although the pathophysiology of AECS has not been formally established, Rorabeck and MacNab proposed that exercise or extreme exertion may lead to an increase in compartment contents through a combination of acute muscular hypertrophy and fluid accumulation.…”

Section: Discussionmentioning

confidence: 99%

Acute Exertional Compartment Syndrome of the Forearm

Dhawan

Borschel

Brown

2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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A cute and chronic exertional (nontraumatic) compartment syndromes are well-documented in the lower leg. We present a case of acute exertional compartment syndrome of the forearm in a teenager. Decompressive fasciotomy was performed, resulting in full preservation of upper extremity function. We highlight the features of her management and present a literature review of this rare clinical entity. CASE REPORTA 19-year-old, right hand dominant woman presented to the emergency department in the early morning, complaining of pain and swelling of the right wrist and forearm which had begun the previous night, 9 hours earlier. She was newly employed as a cake decorator, and had been decorating a cake for one and one half hours. She recalled applying substantial, prolonged pressure using her right hand to squeeze icing out of a decorating bag. After completing this activity, she felt pain over her right wrist and forearm, which progressed gradually throughout the evening and night, finally awakening her from sleep. Over-the-counter analgesics did not relieve her pain. On examination in the emergency department, there was marked swelling over her proximal right forearm and tightness to palpation of the dorsal and volar forearm compartments and the mobile wad (Fig. 1A). Pain was elicited on passive extension of the right wrist and fingers. Her two-point discrimination was 4 mm or less in all the digits. Radial and ulnar pulses were palpable at the wrist, and there was brisk capillary refill in all fingertips. Radiographs of the right wrist and forearm did not demonstrate any bony abnormalities.Compartment pressures were measured using a handheld pressure monitoring system (Stryker Instruments, Kalamazoo, Mich.). Volar and dorsal compartment pressures were found to be 22 mm Hg and 35 mm Hg, respectively. Complete blood count and electrolytes were normal, but her serum creatinine kinase was elevated at 15,500 IU/L (normal Ͻ180). Decompressive forearm fasciotomy was scheduled emergently.The compartment pressures were checked again intraoperatively using an arterial line set-up, and were found to have risen to 41 mm Hg in the volar and 43 mm Hg in the dorsal forearm compartments. Surgical decompression of the volar compartment was performed through a standard incision on the volar forearm. Healthy-appearing muscles of the volar forearm ballooned out through the fasciotomy incision (Fig. 1B). The forearm fascia was released completely up to the carpal tunnel. After release, volar forearm pressures decreased to 4 mm Hg. We considered surgical release of the carpal tunnel at that time, as this maneuver is a valid and logical thought while performing volar forearm release in most instances. In our case, however, the carpal tunnel did not seem to be involved, as it did not appear to be tight upon probing with the insertion of an instrument, and thus it was not released. Pressure in the mobile wad compartment decreased after volar compartment release, but remained elevated at 25 mm Hg. Therefore, decompressive fasciotomy of the do...

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Section: Discussionmentioning

confidence: 99%

Acute Exertional Compartment Syndrome of the Forearm

Dhawan

Borschel

Brown

2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…Some have suggested that the extensive use of gas handles during motocross may lead to forearm flexor compartment overuse. 1 However, the present study demonstrates that almost all individuals (23/24) reported complaints on both arms with identical VAS scores. It is therefore believed that CECS results from the continuous correction and stabilization of both intensely vibrating bars of the steering wheel.…”

Section: Discussionmentioning

confidence: 82%

“…** Some professions or hobbies are associated with forearm CECS including weight training, 4,21 climbing, 6,44 manufacture assembly working, 28 and motocross riding or motor racing. 1,6,16,22,23,44 The present study is the largest cohort of patients with forearm CECS due to motocross. The results indicate that partial fasciectomy or fasciotomy are both successful procedures in the long term.…”

Section: Discussionmentioning

confidence: 99%

Long-term Results of Surgical Decompression of Chronic Exertional Compartment Syndrome of the Forearm in Motocross Racers

et al. 2011

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“…Overall, ten studies (with 60 patients overall) reported results in the motorcycling/motocross racers population. 5,[7][8][9][10][11][12]14,16,26 Forty-one of these patients were treated using MOF 5,12,14 with a mean success rate of 83% and 12 with WOF with a success rate of 95%. However, some of the MOF patients had additional fasciectomies to the standard MOF, as per the surgeon's preference.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] Chronic exertional compartment syndrome of the forearm has been identified in specific athletic population, namely, the motorcycling racers. [5][6][7][8][9][10][11] If nonoperative treatment fails, open or mini-invasive fasciotomy or partial fasciectomy may prove successful. 5,[12][13][14][15] Nowadays, the choice of performing an open fasciectomy versus mini-invasive fasciectomy remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Surgical Decompression of Exertional Compartment Syndrome of the Forearm in Professional Motorcycling Racers

Haddad

Correa-Vázquez

Segura

et al. 2016

Clinical Journal of Sport Medicine

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Chronic Compartment Syndrome of the Flexor Muscles in the Forearm: A Case Report

Abstract: A case is reported of a professional racing motor-cyclist who developed a chronic compartment syndrome of the flexor muscles in the forearm, confirmed by pressure measurements after exercise. Open fasciotomy of both the superficial and deep compartments cured the condition.

Cited by 44 publications

References 6 publications

Acute Exertional Compartment Syndrome of the Forearm

Acute Exertional Compartment Syndrome of the Forearm

Long-term Results of Surgical Decompression of Chronic Exertional Compartment Syndrome of the Forearm in Motocross Racers

Surgical Decompression of Exertional Compartment Syndrome of the Forearm in Professional Motorcycling Racers

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