Patient-Reported Outcomes Following Fasciotomy for Chronic Exertional Compartment Syndrome

Abstract

Level IV: Case series.

Outcomes of Surgically Treated Chronic Exertional Compartment Syndrome in Runners

“…The overall patient satisfaction rate in the current series (78.1%) falls within the range described in other recent studies, such 84% by Campano et al, 6 76% by Micheli et al, 16 76% by Pasic et al, 18 and 60% by Slimmon et al 26 The mean percentage pain relief of 77.5% in the current series is similar to the 68% rate reported by Howard et al 11 Abramowitz and Schepsis 1 have suggested that fasciotomies in the deep posterior compartment may not relieve pain, and this is supported by additional studies that have found better pain improvement after release of the anterior/lateral compartments compared with the deep posterior compartment. 11,21,22,24 Regarding surgical technique, Maher et al 14 noted that patients achieve greater postoperative satisfaction and higher rates of return to sport (91% vs 66%) when all 4 compartments are released versus individual compartments. Beck et al 3 similarly noted that pediatric patients with isolated compartment release had higher rates of failure and reoperation than those with 4-compartment releases.…”

Two-Compartment or 4-Compartment Fasciotomy for Lower Leg Chronic Exertional Compartment Syndrome: A Systematic Review

“…Characteristics of the seven studies (29)(30)(31)(32)(33)(34)(35) are presented in table 1. A total of 194 patients (100 male, 94 female) with a mean age of 24 years (range 15-55) were analyzed.…”

“…A total of 194 patients (100 male, 94 female) with a mean age of 24 years (range 15-55) were analyzed. Six studies (29)(30)(31)(32)(33)(34) were retrospective cohort studies while one study (35) was a prospective cohort study. In six articles (29)(30)(31)(32)(33)35) study groups were allocated according to a two (2-CF) or four (4-CF) compartment release.…”

“…Six studies (29)(30)(31)(32)(33)(34) were retrospective cohort studies while one study (35) was a prospective cohort study. In six articles (29)(30)(31)(32)(33)35) study groups were allocated according to a two (2-CF) or four (4-CF) compartment release. The seventh study (34) compared outcomes of four groups having a different number of released compartments.…”

“…The seventh study (34) compared outcomes of four groups having a different number of released compartments. Six (29)(30)(31)(33)(34)(35) of seven studies presented in total 92 patients undergoing a 2-CF approach and 40 patients a 4-CF. Instead of stating the number of patients per group, the seventh study (32) reported that a 2-CF technique CECS: chronic exertional compartment syndrome, ICP: intra-compartmental pressure, 4-CF: four-compartment fasciotomy, 2-CF: two-compartment fasciotomy, SD: standard deviation, ES: effect sizes, OR: odds ratio, CI: confidence Interval, SMD: standardized mean difference, CASP: Critical Appraisal Skills Programme, GRADE: Grading of Recommendations Assessment, Development and Evaluation, EQ-5D: European Quality of Life -Five Dimensions questionnaire 12 was performed 48 times and 4-CF 15 times.…”