scholarly journals Acute Exertional Compartment Syndrome: A Case Series and Review of the Literature

2021 ◽  
pp. 100040
Author(s):  
Matthew Griffith ◽  
Joshua Hattaway ◽  
Ryan Griffith ◽  
Frederick O'Brien ◽  
Jeannie Huh
Keyword(s):  
Compartment Syndrome ◽  
Case Series ◽  
Review Of The Literature ◽  
Exertional Compartment Syndrome

scholarly journals Chronic exertional compartment syndrome of the forearm: a case series of 12 patients treated with fasciotomy

2011 ◽  
Vol 36 (5) ◽  
pp. 413-419 ◽  
Author(s):  
J. S. Brown ◽  
P. C. Wheeler ◽  
K. T. Boyd ◽  
M. R. Barnes ◽  
M. J. Allen
Keyword(s):  
Compartment Syndrome ◽  
Surgical Intervention ◽  
Case Series ◽  
Chronic Exertional Compartment Syndrome ◽  
Catheter Technique ◽  
Percentage Improvement ◽  
Patient Reported ◽  
Exertional Compartment Syndrome ◽  
Outcome Of Surgery

Chronic exertional compartment syndrome of the forearm is rare in the published literature. We report the outcome of a series of 12 patients treated with fasciotomy over a 14 year period. All patients underwent dynamic intra-compartmental pressure testing using a slit catheter technique before surgery. Raised intra-compartmental pressures on exercise, typical symptoms and the absence of other diagnoses were criteria for offering surgical intervention. The superficial flexor, deep flexor and extensor compartments were released. Median follow-up was 9.5 years (range 7 months to 12 years). Median patient-reported percentage improvement after surgery was 88% (range 0%–100%). Median time to return to full activity was 9 weeks. Eleven out of 12 patients were satisfied, very satisfied or extremely satisfied with the outcome of surgery. Fasciotomy can be an effective treatment for chronic exertional compartment syndrome of the forearm.

scholarly journals Outcomes of Surgically Treated Chronic Exertional Compartment Syndrome in Runners

2020 ◽  
Vol 12 (3) ◽  
pp. 304-309
Author(s):  
Matthew Salzler ◽  
Kathleen Maguire ◽  
Benton E. Heyworth ◽  
Adam Y. Nasreddine ◽  
Lyle J. Micheli ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Revision Surgery ◽  
Case Series ◽  
Activity Level ◽  
Return To Sports ◽  
Recurrent Pain ◽  
Chronic Exertional Compartment Syndrome ◽  
Running Activity ◽  
Exertional Compartment Syndrome ◽  
The Mean

Background: Chronic exertional compartment syndrome (CECS) is primarily seen in running athletes. Previous outcomes of surgical treatment with fasciotomy have suggested moderate pain relief, but evidence is lacking regarding postoperative return to running. Hypothesis: Running athletes with limiting symptoms of CECS will show high rates of return to running after fasciotomy. Study Design: Case series. Level of Evidence: Level 4. Methods: Running athletes treated with fasciotomy for CECS at a single institution were identified using a surgical database and asked to complete a questionnaire designed to assess postoperative pain, activity level, return to running, running distances, overall satisfaction, and rate of revision fasciotomy. Results: A total of 43 runners met the inclusion criteria, and 32 runners completed outcomes questionnaires at a mean postoperative follow-up of 66 months. In total, 27 of these 32 patients (84%) returned to sport(s) after fasciotomy. However, 9 (28%) of these patients pursued nonrunning sports, 5 (16%) due to recurrent pain with running. Of the 18 patients who returned to running sports (56%), the mean weekly running distance decreased postoperatively. Recurrence of symptoms was reported in 6 patients (19%), 4 of whom had returned to running and 2 of whom had been unable to return to sports. All of these 6 patients elected to undergo revision fasciotomy surgery. Twenty-five (78.1%) patients reported being satisfied with their procedure. In the overall cohort, the mean visual analog scale scores for pain during activities/sports decreased from 7.9 preoperatively to 1.7 postoperatively. Conclusion: Fasciotomy for CECS in runners may provide significant improvement in pain and satisfaction in over three-quarters of patients and return to sports in 84% of patients. However, only 56% returned to competitive running activity, with a subset (19%) developing recurrent symptoms resulting in revision surgery. Clinical Relevance: Fasciotomy has been shown to decrease pain in most patients with CECS. This study provides outcomes in running athletes after fasciotomy for CECS with regard to return to sports, maintenance of sports performance, and rates of revision surgery.

scholarly journals Acute compartment syndrome in children: a case series in 24 patients and review of the literature

2010 ◽  
Vol 35 (4) ◽  
pp. 569-575 ◽  
Author(s):  
József Erdös ◽  
Constantin Dlaska ◽  
Peter Szatmary ◽  
Michael Humenberger ◽  
Vilmos Vécsei ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Case Series ◽  
Acute Compartment Syndrome ◽  
Review Of The Literature

scholarly journals Superficial Peroneal Nerve Injury Risk During a Semiblind Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg: An Anatomical and Clinical Study

2018 ◽  
Vol 40 (3) ◽  
pp. 343-351 ◽  
Author(s):  
Johan A. de Bruijn ◽  
Aniek P. M. van Zantvoort ◽  
Henricus Pieter Hubert Hundscheid ◽  
Adwin R. Hoogeveen ◽  
Joep A. W. Teijink ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Case Series ◽  
Superficial Peroneal Nerve ◽  
Anterior Compartment ◽  
Chronic Exertional Compartment Syndrome ◽  
Sensory Deficits ◽  
Clinical Series ◽  
Exertional Compartment Syndrome

Background: Up to 8% of patients who underwent a fasciotomy for leg anterior chronic exertional compartment syndrome (ant-CECS) report sensory deficits suggestive of iatrogenic superficial peroneal nerve (SPN) injury. In the current study we aimed to thoroughly assess the risk of SPN injury during a semiblind fasciotomy of the anterior compartment using 2 separate approaches. Methods: A modified semiblind fasciotomy of the anterior compartment was performed via a longitudinal 2-cm skin incision 2 cm lateral of the anterior tibial crest halfway along the line fibular head-lateral malleolus both in cadaver legs and in patients with ant-CECS. In the cadaver legs, the skin was removed after the procedure and possible SPN injuries and spatial relationships between the SPN and the opened fascia were studied. Between January 2013 and December 2016, 64 ant-CECS patients who underwent a fasciotomy of the anterior compartment were prospectively followed. Iatrogenic SPN injuries were assessed using questionnaires and physical examinations. Results: Macroscopic SPN nerve injury was not observed in any of the 9 cadaver legs. In 8 specimens, the SPN was located at least 5 mm posterolateral to the opened fascia. In 1 specimen, an undamaged SPN branch crossed the operative field in a ventral plane. De novo sensory deficits suggestive for iatrogenic SPN injury were not observed in any of the 64 patients (120 legs; 36 females; median age, 22 years) who underwent a fasciotomy of the anterior compartment. Conclusion: The proposed semiblind fasciotomy for treatment of ant-CECS was not associated with SPN injury in either the cadaveric study or our clinical series. Level of Evidence: Level IV, case series.

Patient-Reported Outcomes Following Fasciotomy for Chronic Exertional Compartment Syndrome

2018 ◽  
Vol 11 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Jacqueline M. Maher ◽  
Emily M. Brook ◽  
Christopher Chiodo ◽  
Jeremy Smith ◽  
Eric M. Bluman ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Compartment Syndrome ◽  
Patient Reported Outcomes ◽  
Case Series ◽  
Lower Extremity Function ◽  
Five Dimensions ◽  
Chronic Exertional Compartment Syndrome ◽  
Patient Reported ◽  
Exertional Compartment Syndrome

Background. Lower extremity chronic exertional compartment syndrome (CECS) can negatively affect exercise and activity and may require operative intervention to release the fascia. Few studies have evaluated or compared patient-reported outcomes for bilateral versus single-leg staged fasciotomy and number of compartments released. Methods. A total of 27 eligible patients who underwent a fasciotomy procedure for CECS at a single institution were identified. A retrospective review of the medical record was performed, and individuals were contacted by phone to collect patient-reported outcomes, including ability to return to desired exercise level, postoperative expectation assessment, European Quality of Life—Five Dimensions, and the Foot and Ankle Ability Measure sports subscale. Results. A total of 21 patients were available for follow-up (average follow-up 36.9 months). The average single numeric assessment evaluation of lower-extremity function in sport was 87.5% in those who underwent a simultaneous bilateral fasciotomy (n = 10), 94% in those who had a staged unilateral fasciotomy (n = 5), and 74% in those who underwent an isolated single-leg fasciotomy. In all, 91% (n = 10) of patients who had all 4 compartments released intra-operatively were able to return to their desired exercise level versus 66.7% (n = 6) of those who did not have all 4 compartments released. Conclusion. The patient-reported outcomes of a staged unilateral fasciotomy and simultaneous bilateral fasciotomy for CECS are similar. Those who did not have all 4 compartments released reported worse outcomes. Further research should be conducted on the short-term outcomes and cost-effectiveness of a bilateral versus staged fasciotomy procedure. Levels of Evidence: Level IV: Case series

scholarly journals Isolated Lateral Chronic Exertional Compartment Syndrome of the Leg: A New Entity?

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711989010 ◽  
Author(s):  
Antonia P.M. van Zantvoort ◽  
Henricus P.H. Hundscheid ◽  
Johan A. de Bruijn ◽  
Adwin R. Hoogeveen ◽  
Joep A.W. Teijink ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Case Series ◽  
Lateral Compartment ◽  
Leg Pain ◽  
Intracompartmental Pressure ◽  
Level Of Evidence ◽  
Anterior Compartment ◽  
Chronic Exertional Compartment Syndrome ◽  
Skin Sensation ◽  
Exertional Compartment Syndrome

Background: Chronic exertional compartment syndrome (CECS) mostly occurs in the anterior or deep posterior compartments (ant-CECS and dp-CECS, respectively) of the leg. It is generally accepted that CECS of the third or lateral compartment (lat-CECS) always occurs together with ant-CECS. However, whether exertional leg pain (ELP) can be caused by an isolated form of lat-CECS is unknown. Purpose: To determine the existence of isolated lat-CECS and study whether history taking and a physical examination aid in discriminating between different subtypes of CECS. Study Design: Case series; Level of evidence, 4. Methods: Patients were eligible for this single-center study, conducted between January 2013 and February 2018, if they reported anterolateral ELP and completed a questionnaire scoring the frequency and intensity of pain, tightness, cramps, muscle weakness, and paresthesia during rest and exercise. They were asked to mark areas of altered foot skin sensation, if present, on a drawing. All patients underwent a dynamic intracompartmental pressure (ICP) measurement of the anterior and lateral compartments simultaneously. The diagnosis of CECS was confirmed by elevated ICP (Pedowitz criteria). There were 3 patient groups: (1) isolated ant-CECS with elevated ICP in the anterior compartment and normal ICP in the lateral compartment, (2) isolated lat-CECS with elevated ICP in the lateral compartment but normal ICP in the anterior compartment, and (3) ant-/lat-CECS with elevated ICP in both the anterior and lateral compartments. Results: A total of 73 patients with anterolateral ELP fulfilled study criteria (isolated ant-CECS: n = 26; isolated lat-CECS: n = 5; ant-/lat-CECS: n = 42). Group differences were not observed regarding age (isolated ant-CECS: median, 26 years [range, 13-68 years]; isolated lat-CECS: median, 20 years [range, 17-63 years]; ant-/lat-CECS: median, 28 years [range, 17-57 years]; χ2 (2) = 0.466; P = .79), sex (isolated ant-CECS: 50% male; isolated lat-CECS: 40% male; ant-/lat-CECS: 62% male; P = .49), or bilateral symptoms (isolated ant-CECS: 54%; isolated lat-CECS: 80%; ant-/lat-CECS: 69%; P = .40). However, cramps at rest were present in a portion of the patients with isolated ant-CECS (38%) and ant-/lat-CECS (57%) but not in those with isolated lat-CECS ( P = .032). Patient drawings of altered foot skin sensation did not contribute to the diagnosis ( P = .92). ICP values after provocation were all lower in patients with isolated ant-CECS and isolated lat-CECS compared with those with ant-/lat-CECS ( P < .05). Conclusion: Seven percent of patients with CECS and anterolateral ELP who had symptoms due to isolated lat-CECS in the presence of normal muscle pressure in the anterior compartment.

Dorsal Hemi-Lithotomy Position for Femoral Fracture Nailing and the Well Leg Compartment Syndrome. Report of Two Cases, Review of the Literature

Swiss Surgery ◽  
2002 ◽  
Vol 8 (4) ◽  
pp. 193-196 ◽  
Author(s):  
Christodoulou ◽  
Garofalo ◽  
Echeverri ◽  
Pelet ◽  
Mouhsine
Keyword(s):  
Compartment Syndrome ◽  
Femoral Fracture ◽  
Lithotomy Position ◽  
Review Of The Literature ◽  
Revue De La Littérature ◽  
Examen Clinique ◽  
Positionnement Du Patient ◽  
Syndrome Report

Le syndrome de loge sur positionnement prolongé en lithotomie ou en hémilithitomie, est une complication rare en chirurgie. Les dommages neurovasculaires sont souvent permanents. On reporte deux cas d'ostéosynthèse du fémur en position d'hemilithotomie, compliqués d'un syndrome de loge de la jambe controlatérale. Une revue de la littérature sur les 40 cas décrits, jusqu'à ce jour, nous démontre que cette complication est fortement liée au positionnement du patient et à la durée opératoire. Compte tenu du pronostic fonctionnel incertain, une limitation du temps de positionnement en lithotomie doit être recherchée. La surveillance postopératoire doit être rigoureuse et sans hésitation quant à une fasciotomie éventuelle sur simple examen clinique ou après la mesure de la pression dans les loges. Une technique de positionnement sur la table orthopédique est proposée.

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