scholarly journals Forearm compartment pressures and grip strength in elite motorbike racers with chronic exertional compartment syndrome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Dominic P. O’Dowd ◽  
Heike Romer ◽  
Richard Hughes ◽  
Noel Harding ◽  
Samantha Ball ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Grip Strength ◽  
Exercise Programme ◽  
Post Exercise ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Before And After ◽  
The Mean ◽  
Compartment Pressures ◽  
Forearm Flexor

Abstract Background Remarkably little research has been published on chronic exertional compartment syndrome (CECS) of the forearm. This study investigated forearm flexor compartment pressure pre- and post-exercise in elite motorbike racers clinically diagnosed with CECS and assessed their grip strength before and after arm pump exercise. Methods Elite motorbike riders with a clinical diagnosis of CECS of the right forearm when racing were recruited during the opening rounds of a British Superbike season. Their grip strength and forearm flexor compartment pressures were measured before and after a set exercise programme. Results Of the 11 riders recruited to the study, 10 completed the full testing regime. The mean pre-exercise forearm compartment pressures [11.7 mmHg (range 7–17 mmHg)] significantly increased post-exercise [30.5 mmHg (range 15–45 mmHg)], with a mean increase of 18.80 mmHg (P < 0.0001). The mean pre-exercise grip strength [50.61 mmHg (range 37–66.7 mmHg)] decreased post-exercise to [35.62 mmHg (range 17.1–52.5 mmHg)], a mean decrease of 14.99 mmHg (P < 0.0001). Conclusion There is a statistically significant increase in the forearm flexor compartment pressures in elite motorbike racers with CECS, but with marked variability of these values. Grip strength decreases statistically significantly following onset of symptoms of CECS of the forearm.

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

2021 ◽  
Author(s):  
William M. Oliver ◽  
Dominic Rhatigan ◽  
Samuel P. Mackenzie ◽  
Timothy O. White ◽  
Andrew D. Duckworth ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Lower Limb ◽  
Return To Sport ◽  
Leg Pain ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
The Mean ◽  
Active Adults ◽  
Eq Vas ◽  
Mini Open

AbstractPurposeThe aim of this study was to report outcomes following mini-open lower limb fasciotomy (MLLF) in active adults with chronic exertional compartment syndrome (CECS).MethodsFrom 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).ResultsComplications 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 (bothp < 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.ConclusionMLLF 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.

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 Diagnosis of chronic exertional compartment syndrome by post-exercise MRI

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0000
Author(s):  
Vicente Paús ◽  
Ariel Graieb ◽  
Federico Torrengo ◽  
Francisco Villalba
Keyword(s):  
Compartment Syndrome ◽  
Gold Standard ◽  
Leg Pain ◽  
Intracompartmental Pressure ◽  
Post Exercise ◽  
Chronic Exertional Compartment Syndrome ◽  
Hyperintense Signal ◽  
Exertional Compartment Syndrome ◽  
Attractive Option ◽  
Post Stress

Objective: Chronic exertional compartment syndrome (CECS) is the cause of 27% of anterior leg pain in athletes. The source of pain in this condition is still debated. Measurement of intracompartmental pressure is the gold standard diagnosis, albeit an invasive study. The development and interpretation of new MRI sequences has provided a non-invasive alternative to CECS diagnosis. Post-exercise MRI is an attractive option, which is currently undergoing its validation process. Methods: 22 patients with a clinical diagnosis of CECS were included, with a median follow-up of 5 years (1-10 years). All the patients were evaluated by clinical examination, pre- and post-exercise MRI and pre-and post-exercise intracompartmental pressure measurement. Pressure was measured with Whitesides technique, and diagnosis was carried out by Pedowitz criteria. Results: Out of the total 22 patients, 19 had positive intracompartmental measurement (15 male, 4 female) and 3 had negative measurement. All the patients had a normal MRI at rest. The three patients who had negative intracompartmental measurement had a normal post-stress MRI. Out of the remaining 19 patients, the MRI detected hyperintense signal in T2 and STIR weighted in 15 of them (78,95%). Conclusions: MRI could be relevant for diagnosis, for which case the sensitivity of this method should be improved. Nevertheless, pre- and post-stress intracompartmental measurement continues to be the gold standard.

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.

Post-Exertional MRI Is Useful as a Tool for Diagnosis and Treatment Evaluation for Chronic Exertional Compartment Syndrome of Forearms

2019 ◽  
Vol 24 (03) ◽  
pp. 311-316 ◽  
Author(s):  
Akiko Tominaga ◽  
Kozo Shimada ◽  
Ko Temporin ◽  
Ryosuke Noguchi
Keyword(s):  
Compartment Syndrome ◽  
Treatment Evaluation ◽  
Diagnosis And Treatment ◽  
Intensity Change ◽  
Flexor Digitorum Profundus ◽  
Mri Findings ◽  
Chronic Exertional Compartment Syndrome ◽  
High Area ◽  
Exertional Compartment Syndrome ◽  
Before And After

Background: Chronic exertional compartment syndrome (CECS) is a rare condition, which generally occurs in athletes. Few tools are available for diagnosis and treatment evaluation. We examined pre- and post- exertional forearm magnetic resonance imaging (MRI) before and after fasciotomy since 2013. The purpose of this study was to evaluate the efficacy of pre- and post-exertional MRI before and after fasciotomy. Methods: We treated 8 forearms of 5 patients diagnosed with CECS of the forearms since 2013, including 6 forearms of 3 motocross racers, 1 forearm of 1 baseball pitcher, 1 forearm of 1 manual laborer with a history of muscle contusion. We obtained pre- and post-exertional MRI before and after fasciotomy in all cases. Pre-exertional MRI was obtained when the patient was at rest without any symptom. Post-exertional MRI was obtained after the patients repeated “grip and release” using a hand gripper with maximum effort for approximately 10 minutes until symptoms occurred. We compared MRI findings before and after fasciotomy and evaluated the correlation with clinical outcome. Results: Symptoms disappeared completely in all 3 motocross racers after fasciotomy. MRI at rest showed no abnormal high signals in all cases both before and after fasciotomy. On post-exertional MRI, T2 high area presented mainly in flexor digitorum profundus (FDP) and brachioradialis (BR) and disappeared completely after surgery. Symptoms persisted in the pitcher and the laborer after fasciotomy. T2 high area presented mainly in FDP on post-exertional MRI before fasciotomy and remained on post-exertional MRI after fasciotomy in these two patients. These intensity changes correlated strongly with their symptoms. Conclusions: We performed pre- and post-exertional MRI before and after fasciotomy. The intensity change in T2-weighted images on post-exertional MRI correlated strongly with their symptoms. Post-exertional MRI is useful for diagnosis and treatment evaluation in CECS.

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