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 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.

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 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 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.

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.

scholarly journals Microdialysis for chronic exertional compartment syndrome: a pilot study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Heinz Lohrer ◽  
Jochen Klein ◽  
Tanja Nauck ◽  
Tobias Schönberg
Keyword(s):  
Pilot Study ◽  
Compartment Syndrome ◽  
Level Of Evidence ◽  
Chronic Exertional Compartment Syndrome ◽  
Control Subjects ◽  
Exertional Compartment Syndrome ◽  
Before And After ◽  
Healthy Control ◽  
Exercise Induced ◽  
And Control

Abstract Background Diagnosing chronic exertional compartment syndrome (CECS) is still a challenge. An increase in intramuscular pressure during and following exercise is accepted as the diagnostic standard. However, neither the methods used nor the interpretation of the obtained results are sufficiently standardized. Methods In the present pilot study, the metabolic state of CECS patients was investigated using microdialysis. We hypothesized that there was no difference in intramuscular concentrations of glucose, lactate, glutamate, and glycerol before and after exercise (H10) or between patients suffering from CECS and healthy control subjects (H20). This study was designed as an explorative case-control study (level of evidence III). Twelve patients suffering from CECS of the lower leg and six matched asymptomatic control subjects underwent microdialysis in the anterior (n = 7) or deep posterior compartment (n = 11) of the leg. Following ultrasound-guided insertion of the microdialysis catheters, 10-minute fractions of the dialysates were collected first during rest and then following fatigue- or pain-induced discontinuation of exercise. Dialysates were analysed for lactate, glucose, glutamate, and glycerol concentrations 6 × 10 min before and 6 × 10 min after exercise. Results Exercise-induced increases in lactate, glutamate, and glycerol concentrations were detected in both CECS patients and control subjects (all p < 0.001). No differences between CECS patients and control subjects were found by comparing the intramuscular glucose, lactate, glutamate, and glycerol concentrations at rest and following exercise (all p > 0.05). Conclusions We found exercise-induced increases in the lactate, glutamate, and glycerol levels in skeletal muscle. However, the metabolic changes did not differentiate CECS patients from healthy subjects. Trial registration The registration trial number is DRKS00021589 on DRKS. ‘Retrospectively registered’. Date of registration: April 4, 2020.

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