Intramuscular Pressure and Patient-Reported Outcomes in Patients Surgically Treated for Anterior Chronic Exertional Compartment Syndrome

Lindorsson, Sophia; Zhang, Qiuxia; Brisby, Helena; Rennerfelt, Kajsa

doi:10.1177/23259671221151088

Cited by 3 publications

References 37 publications

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Chronic exertional compartment syndrome of the forearm diagnosed in a wider spectrum of patients and not seldom with a history of the same diagnosis in the lower legs

Sjöcrona,

Lindorsson,

Rennerfelt

2024

J. exp. orthop.

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PurposeTo identify patient characteristics associated with forearm chronic exertional compartment syndrome (CECS) and to demonstrate the distribution of intramuscular pressure (IMP) values at 1 min postexercise in a cohort of patients with exercise‐induced forearm pain.MethodsA consecutive series of 99 patients seeking orthopaedic consultation for chronic exertional forearm pain underwent IMP measurements between 2010 and 2023. The diagnosis of CECS was confirmed (n = 34) or ruled out (n = 65) based on the patient's history, clinical examination and IMP measurements.ResultsThere were significantly more male patients in the CECS group than in the group of patients where the diagnosis was ruled out. Furthermore, a significantly higher proportion of the CECS patients had been previously treated for CECS of the lower legs. The most common occupation was office worker (21%), followed by craftsperson (18%). The most common main physical activities were strength training (21%) and cycling (15%). The median (range) 1‐min postexercise IMP values for patients with CECS were 34 (23–68) mmHg for the flexor compartment and 32 (25–67) mmHg for the extensor compartment.ConclusionThis study demonstrates a more general population of CECS patients compared to previous studies. Notably, more than a fifth of the CECS patients had previously been treated for CECS in the lower legs. Importantly, considering the 95% confidence interval for IMP values in patients without CECS, the most used IMP cutoff value for diagnosing CECS appears to be too high for the forearm compartments.Level of EvidenceLevel II.

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Chronic exertional compartment syndrome of the forearm diagnosed in a wider spectrum of patients and not seldom with a history of the same diagnosis in the lower legs

Sjöcrona,

Lindorsson,

Rennerfelt

2024

J. exp. orthop.

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Female patients have greater improvement in pain symptoms and physical activity after fasciotomy for treatment of chronic exertional compartment syndrome of the lower leg

Shankar,

Vasavada,

Gillinov

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of this study was to identify sex differences in postoperative outcomes and return‐to‐sport rates after fasciotomy for treatment of chronic exertional compartment syndrome (CECS) of the lower leg. It was hypothesised that male CECS patients would have a higher rate of return to sport than female CECS patients.MethodsA retrospective cohort study was conducted involving patients who underwent primary fasciotomy of one to four leg compartments for treatment of CECS at a single centre from 2010 to 2020. Each affected leg was treated as a separate subject. Postoperative outcomes included CECS pain frequency and severity, return to sport and Tegner activity level. Multivariable regression was used to determine if sex was an independent predictor of outcomes after adjusting for demographic and clinical covariates. p < 0.05 were considered significant.ResultsEighty‐one legs (44 M, 37 F) of 47 unique patients (34 of whom had bilateral symptoms) were included with a mean follow‐up time of 51.5 ± 31.4 months. Male subjects were older (p < 0.001) and had higher body mass index (p < 0.001) compared to female subjects. Most subjects (84.0%) underwent two‐ or four‐compartment fasciotomies. Female sex was found to be predictive of lower overall postoperative pain severity (p = 0.007), higher odds of return to sport (p = 0.04) and higher postoperative Tegner score (p = 0.005). However, female sex was not predictive of postoperative pain frequency, odds of reoperation or odds of return to sport to at least the presymptomatic level (all p < 0.05).ConclusionFemale sex is independently predictive of reduced overall pain severity, higher odds of return to sport and higher postoperative improvement in Tegner score following fasciotomy for treatment of lower‐limb CECS.Level of EvidenceIII.

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Compartment Syndromes of the Lower Leg

Halldin Lindorsson,

Rennerfelt

2024

Sports Injuries

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Intramuscular Pressure and Patient-Reported Outcomes in Patients Surgically Treated for Anterior Chronic Exertional Compartment Syndrome

Cited by 3 publications

References 37 publications

Chronic exertional compartment syndrome of the forearm diagnosed in a wider spectrum of patients and not seldom with a history of the same diagnosis in the lower legs

Chronic exertional compartment syndrome of the forearm diagnosed in a wider spectrum of patients and not seldom with a history of the same diagnosis in the lower legs

Female patients have greater improvement in pain symptoms and physical activity after fasciotomy for treatment of chronic exertional compartment syndrome of the lower leg

Compartment Syndromes of the Lower Leg

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