Two minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg

Mouhsine, Elyazid; Garofalo, Raffaele

doi:10.1007/s00167-006-0247-y

Cited by 10 publications

(15 citation statements)

References 11 publications

(31 reference statements)

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“…Anterior and lateral fasciotomies have the best outcome with a greater than 80% success rate [10,11,17]. Deep posterior fasciotomies have a lower success rate of 50% [5,10,23]. Decreased success in the release of the deep posterior compartment has been attributed to more complex anatomy, poor visualization, and inaccessible small muscular subdivisions [19].…”

Section: Treatmentmentioning

confidence: 99%

“…Subcutaneous fasciotomy involves one to two small incisions [3,7]. There have been several case studies involving endoscopically assisted subcutaneous fasciotomy [18,20,21,23,31]. There are reports of increased complication rate and symptom reoccurrence with the subcutaneous method [21,23,27].…”

Section: Treatmentmentioning

confidence: 99%

“…There have been several case studies involving endoscopically assisted subcutaneous fasciotomy [18,20,21,23,31]. There are reports of increased complication rate and symptom reoccurrence with the subcutaneous method [21,23,27]. Unsuccessful subcutaneous fasciotomy is attributed to incomplete fascial release, nerve injury, and unrecognized fascial defect or muscle herniation [21].…”

Section: Treatmentmentioning

confidence: 99%

“…Patients are encouraged to do range of motion exercise and weight-bearing exercises immediately after surgery to prevent adhesions and scaring [22,23,31,32]. Cycling and swimming can be started as soon as incisions are healed [8,26].…”

Section: Treatmentmentioning

confidence: 99%

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Chronic exertional compartment syndrome of the leg

Tucker

2010

Curr Rev Musculoskelet Med

115

139

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Chronic exertional compartment syndrome (CECS) is an underdiagnosed cause of chronic exertional leg pain. The syndrome most commonly occurs in young adult recreational runners, elite athletes, and military recruits. CECS is caused by increased intracompartmental pressure within a fascial space; however, the mechanism of why pain occurs is unknown. Symptoms are classically pain in the affected compartment at the same time, distance, or intensity of exercise. CECS is a clinical diagnosis; however, it is confirmed by intracompartmental pressure testing. Fasciotomy is the treatment of choice for athletes who would like to maintain the same level of activity. Athletes who have a release of the anterior and lateral compartments have a high success rate.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Chronic exertional compartment syndrome of the leg

Tucker

2010

Curr Rev Musculoskelet Med

115

139

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“…The diagnostic workup in addition to the clinical investigation includes MRI and invasive compartment pressure measurements under rest and exercise. Even with the risk of collateral damages (Hutchinson et al 2003), the symptom-orientated surgical intervention with a minimal-invasive fasciotomia (Mouhsine et al 2006) has to be considered after failed conservative pressure reduction and resulting danger of chronic damage (See Fig. 3a, b).…”

Section: Overuse Injuriesmentioning

confidence: 99%

Biathlon: Acute Trauma and Overuse Injuries

Disch

2013

Sports Injuries

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Biathlon is an Olympic winter sport combining mid-distance cross-country skiing and intermittent exercises of rifle shooting. Its close relation to cross-country skiing and the similarity in training and preparation for the season explains the pattern of acute injuries and repetitive strain syndromes. Acute injuries are very rare. However, if they appear, the whole spectrum of medical support has to be applied in order to minimize long-term damage and injuries related to fractures or soft-tissue damages. Overuse injuries are very common and show a variety of symptoms relating to multiple musculoskeletal pathologies. The main focus is on the shoulder girdle, the low lumbar back and sacroiliac joint, the knee, as well as the lower limb and ankle. Due to the high-level performance of biathlon and the immense training volume and intensity, continuous medical care and attention is highly recommended. Historical OverviewBiathlon (Greek for "two contests") is an Olympic winter sport, consisting of cross-country skiing and interjectional rifle shooting. Since 1985 the mandatory technique for the cross-country skiing part of the sport is the skating technique. The origin of this combination of skiing and shooting is found in the hunter-gatherer period, when game was hunted on ski-like objects and by bow and arrow. Historic findings of Arctic arts of the Stone Age show a skiing bowman, dating back to the second millennium BC among others. The earliest written records of skiing for the purpose of hunting can be found in the histories of the Romans, Greeks, and Chinese. For example, the Roman poet Virgil had already described hunting on skis as early as 400 BC. A second aspect in the development of this sport is the long-standing tradition of military skiing, which has been in existence in Scandinavian countries and Russia since the year 1550 with independent ski regiments, later spreading to Central Europe.Special bore rifles (5.6 mm) with open sight and manual loading are used for shooting at five targets from a distance of 50 m. The circular metal targets used for prone shooting are 45 mm in diameter, while the targets, which are shot at from a standing position, are 115 mm in diameter.

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Outcome following mini-open lower limb fasciotomy for chronic exertional compartment syndrome

Oliver

Rhatigan

Mackenzie

et al. 2021

Eur J Orthop Surg Traumatol

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Purpose The aim of this study was to report outcomes following mini-open lower limb fasciotomy (MLLF) in active adults with chronic exertional compartment syndrome (CECS). Methods From 2013–2018, 38 consecutive patients (mean age 31 years [16–60], 71% [n = 27/38] male) underwent MLLF. There were 21 unilateral procedures, 10 simultaneous bilateral and 7 staged bilateral. There were 22 anterior fasciotomies, five posterior and 11 four-compartment. Early complications were determined from medical records of 37/38 patients (97%) at a mean of four months (1–19). Patient-reported outcomes (including EuroQol scores [EQ-5D/EQ-VAS], return to sport and satisfaction) were obtained via postal survey from 27/38 respondents (71%) at a mean of 3.7 years (0.3–6.4). Results Complications occurred in 16% (n = 6/37): superficial infection (11%, n = 4/37), deep infection (3%, n = 1/37) and wound dehiscence (3%, n = 1/37). Eight per cent (n = 3/37) required revision fasciotomy for recurrent leg pain. At longer-term follow-up, 30% (n = 8/27) were asymptomatic and another 56% (n = 15/27) reported improved symptoms. The mean pain score improved from 6.1 to 2.5 during normal activity and 9.1 to 4.7 during sport (both p < 0.001). The mean EQ-5D was 0.781 (0.130–1) and EQ-VAS 77 (33–95). Of 25 patients playing sport preoperatively, 64% (n = 16/25) returned, 75% (n = 12/16) reporting improved exercise tolerance. Seventy-four per cent (n = 20/27) were satisfied and 81% (n = 22/27) would recommend the procedure. Conclusion MLLF is safe and effective for active adults with CECS. The revision rate is low, and although recurrent symptoms are common most achieve symptomatic improvement, with reduced activity-related leg pain and good health-related quality of life. The majority return to sport and are satisfied with their outcome.

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Two minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg

Cited by 10 publications

References 11 publications

Chronic exertional compartment syndrome of the leg

Chronic exertional compartment syndrome of the leg

Biathlon: Acute Trauma and Overuse Injuries

Outcome following mini-open lower limb fasciotomy for chronic exertional compartment syndrome

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