Simultaneous 4 Compartment Pressure Monitoring in Diagnosis of Chronic Exertional Compartment Syndrome of the Forearm

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alasdair R. Bott ◽  
Jaroslav Roszpopa ◽  
Phillip Johnston ◽  
Ian Grant
Keyword(s):  
Compartment Syndrome ◽  
Compartment Pressure ◽  
Pressure Monitoring ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome

scholarly journals Endoscopic Fascia Release for Forearm Chronic Exertional Compartment Syndrome: Case Report and Surgical Technique

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP58-NP61 ◽  
Author(s):  
Elizabeth A. Miller ◽  
Anna L. Cobb ◽  
Tyson K. Cobb
Keyword(s):  
Case Report ◽  
Compartment Syndrome ◽  
Single Incision ◽  
Invasive Technique ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Before And After ◽  
History Of ◽  
Forearm Pain

Background: Chronic exertional compartment syndrome (CECS) of the forearm is traditionally treated with open compartment release requiring large incisions that can result in less than optimal esthetic results. The purpose of this study is to describe a case report of 2 professional motocross patients with forearm CECS treated endoscopically using a minimally invasive technique. Methods: Two professional motocross racers presented with a history of chronic proximal volar forearm pain when motocross riding. Other symptoms included paresthesia and weakness, which, at times, led to an inability to continue riding. Both failed conservative management. Compartment pressure measurements were performed before and after provocative exercises to confirm diagnosis of CECS. Release of both the volar and dorsal compartments was performed endoscopically through a single incision. Results: Symptoms resolved after surgery. The first patient resumed riding at 1 week, competing at 3 weeks, and continues to ride competitively without symptoms at 3 years postoperative. The second patient began riding at 1 week and won second place in the National Supercross finals 5 weeks after simultaneous bilateral release. Conclusions: This technique is simple and effective. The cannula used protects the superficial nerves while allowing release through a small, cosmetically pleasing incision.

scholarly journals Chronic Exertional Compartment Syndrome in a High School Soccer Player

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
James J. Bresnahan ◽  
William L. Hennrikus
Keyword(s):  
High School ◽  
Compartment Syndrome ◽  
Soccer Player ◽  
Rare Condition ◽  
Leg Pain ◽  
Intramuscular Pressure ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Life Improvement

Chronic exertional compartment syndrome (CECS) is a relatively rare condition that affects young adult athletes and often causes them to present to the emergency department. If left untreated, those who continue to compete at high levels may experience debilitating leg pain. Physicians may have difficulty differentiating CECS from other syndromes of the lower leg such as medial tibial stress syndrome, stress fractures, and popliteal artery entrapment. The gold standard for diagnosing CECS is intramuscular compartment pressure monitoring before and/or after 10 minutes of exercise. Some patients may choose to stop participation in sports in order to relieve their pain, which otherwise does not respond well to nonoperative treatments. In patients who wish to continue to participate in sports and live an active life, fasciotomy provides relief in 80% or more. The typical athlete can return to training in about 8 weeks. This is a case of a high school soccer player who stopped competing due to chronic exertional compartment syndrome. She had a fascial hernia, resting intramuscular pressure of 30 mmHg, and postexercise intramuscular pressure of 99 mmHg. Following fasciotomy she experienced considerable life improvement and is once again training and playing soccer without symptoms.

Chronic exertional compartment syndrome of the foot. A case report

1998 ◽  
Vol 88 (1) ◽  
pp. 21-24 ◽  
Author(s):  
MB Mollica
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Compartment Syndrome ◽  
Clinical Examination ◽  
Subjective Symptoms ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Pressure Testing ◽  
Exertional Compartment Syndrome

The author describes a case of chronic exertional compartment syndrome of the foot affecting a 19-year-old male triathlete. Relevant anatomy, subjective symptoms, and clinical examination are discussed. Diagnostic confirmation, as achieved with compartment-pressure testing, is also presented, as is surgical treatment through decompressive fasciotomy of the affected compartment.

scholarly journals Chronic Exertional Compartment Syndrome: A Review of Literature

2022 ◽  
Vol 5 (1) ◽  
pp. 01-03
Author(s):  
Phillip J Stokey ◽  
Sreeram Ravi ◽  
Ethan R Sawyer ◽  
Trevor T Bouck ◽  
Nabil A Ebraheim
Keyword(s):  
Compartment Syndrome ◽  
Review Of Literature ◽  
Compartment Pressure ◽  
Time Intervals ◽  
Chronic Exertional Compartment Syndrome ◽  
Level Of Activity ◽  
Exertional Compartment Syndrome ◽  
Before And After ◽  
Vascular Compromise ◽  
Proper Diagnosis

Chronic exertional compartment syndrome (CECS) is a serious, yet underdiagnosed condition that can cause severe lower extremity pain in running athletes. CECS is a transient increase in compartment pressure leading to severe pain, paresthesia, and vascular compromise. Understanding the detailed anatomy is paramount to proper diagnosis and treatment. Diagnosis is made with measuring compartments pressures before and after exercise at certain time intervals. When properly diagnosed and treated, CECS can be appropriately managed and patients can return to their previous level of activity.

scholarly journals Role of Repeat Muscle Compartment Pressure Measurements in Chronic Exertional Compartment Syndrome of the Lower Leg

2017 ◽  
Vol 5 (6) ◽  
pp. 232596711771112 ◽  
Author(s):  
Aniek P. M. van Zantvoort ◽  
Johan A. de Bruijn ◽  
Michiel B. Winkes ◽  
Adwin R. Hoogeveen ◽  
Joep A. W. Teijink ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Lower Leg ◽  
Pressure Measurements ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Muscle Compartment

Bilateral Simultaneous Fasciotomy for Chronic Exertional Compartment Syndrome

2005 ◽  
Vol 26 (12) ◽  
pp. 1007-1011 ◽  
Author(s):  
Steven M. Raikin ◽  
Venkat R. Rapuri ◽  
Peter Vitanzo
Keyword(s):  
Compartment Syndrome ◽  
Operative Procedure ◽  
Sports Participation ◽  
Return To Sports ◽  
Complication Rates ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Early Return ◽  
Exertional Compartment Syndrome ◽  
Before And After

Background: Chronic exertional compartment syndrome (CECS) occurs bilaterally in approximately 60% of patients. Fasciotomy is the primary corrective treatment. We hypothesized that bilateral fasciotomy can be done during the same operative procedure with early return to sports and low complication rates. Method: Sixteen patients had simultaneous bilateral lower extremity fasciotomies for CECS confirmed by compartment pressure testing before and after exercise. Ten patients had concomitant superficial peroneal neurolysis for associated numbness. All patients who were athletes (six runners; nine ball sports) (average age 25 years) had sports related pain limiting participation. Results: Patients were followed for an average of 16.4 (range 6 to 48) months. Full return to sports participation occurred at an average of 10.7 weeks. Three patients continued to have mild, but much improved, pain with active sports participation, while 13 were pain free. All 11 patients with exertional related numbness had resolution after operative release. All patients were satisfied and all patients stated that they would have simultaneous fasciotomies again if required. As a nonmatched comparison, three patients who had staged fasciotomies for bilateral CECS were also evaluated, but because of the small number no statistical comparison was made. All three also returned to their previous levels of sports participation, however, at an average of 22.7 months as compared to 10.7 weeks in patients with simultaneous bilateral releases. Conclusion: Bilateral simultaneous fasciotomies for CECS can be done safely and effectively with early return to sports participation and low complication rates.

scholarly journals Effects of anterior compartment fasciotomy on intramuscular compartment pressure in patients with chronic exertional compartment syndrome

2018 ◽  
Vol 164 (5) ◽  
pp. 338-342 ◽  
Author(s):  
David Roscoe ◽  
A J Roberts ◽  
D Hulse ◽  
A F Shaheen ◽  
M P Hughes ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Symptomatic Improvement ◽  
Control Group ◽  
Compartment Pressure ◽  
Anterior Compartment ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Group 2 ◽  
Asymptomatic Control

BackgroundPatients with chronic exertional compartment syndrome (CECS) have pain during exercise that usually subsides at rest. Diagnosis is usually confirmed by measurement of intramuscular compartment pressure (IMCP) following exclusion of other possible causes. Management usually requires fasciotomy but reported outcomes vary widely. There is little evidence of the effectiveness of fasciotomy on IMCP. Testing is rarely repeated postoperatively and reported follow-up is poor. Improved diagnostic criteria based on preselection and IMCP levels during dynamic exercise testing have recently been reported.Objectives(1) To compare IMCP in three groups, one with classical symptoms and no treatment and the other with symptoms of CECS who have been treated with fasciotomy and an asymptomatic control group. (2) Establish if differences in IMCP in these groups as a result of fasciotomy relate to functional and symptomatic improvement.MethodsTwenty subjects with symptoms of CECS of the anterior compartment, 20 asymptomatic controls and 20 patients who had undergone fasciotomy for CECS were compared. All other possible diagnoses were excluded using rigorous inclusion criteria and MRI. Dynamic IMCP was measured using an electronic catheter wire before, during and after participants exercised on a treadmill during a standardised 15 min exercise challenge. Statistical analysis included t-tests and analysis of variance.ResultsFasciotomy results in reduced IMCP at all time points during a standardised exercise protocol compared with preoperative cases. In subjects responding to fasciotomy, there is a significant reduction in IMCP below that of preoperative groups (P<0.001). Postoperative responders to fasciotomy have no significant differences in IMCP from asymptomatic controls (P=0.182).ConclusionFasciotomy reduces IMCP in all patients. Larger studies are required to confirm that the reduction in IMCP accounts for differences in functional outcomes and pain reductions seen in postoperative patients with CECS.

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