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Int J Sports Med 2021; 42(06): 559-565
DOI: 10.1055/a-1273-7777
Orthopedics & Biomechanics

Chronic Exertional Compartment Syndrome in the Leg: Comparing Surgery to Conservative Therapy

Sanne Vogels 
1   Surgery Department, Alrijne Hospital, Leiderdorp, the Netherlands
2   Surgery Department, Máxima Medical Center, Veldhoven, the Netherlands
,
Ewan D. Ritchie
1   Surgery Department, Alrijne Hospital, Leiderdorp, the Netherlands
,
Henricus PH Hundscheid
2   Surgery Department, Máxima Medical Center, Veldhoven, the Netherlands
,
Kim van Someren
2   Surgery Department, Máxima Medical Center, Veldhoven, the Netherlands
,
Loes Janssen
2   Surgery Department, Máxima Medical Center, Veldhoven, the Netherlands
,
Rigo Hoencamp
1   Surgery Department, Alrijne Hospital, Leiderdorp, the Netherlands
3   Defence Healthcare Organization, Ministry of Defense, Utrecht, the Netherlands
4   Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
5   Trauma Research Unit, Department of Trauma Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
,
Marc R Scheltinga
2   Surgery Department, Máxima Medical Center, Veldhoven, the Netherlands
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Abstract

The aim of this nonrandomized cohort study was to compare the clinical effectiveness of an elective fasciotomy with conservative treatment for chronic exertional compartment syndrome of the leg. Patients diagnosed with chronic exertional compartment syndrome who opted for surgery (n=188) completed a preoperative questionnaire and a 12-month postoperative questionnaire. Patients who continued conservative treatments (n=23) served as controls. Gender, age, sports activity or affected compartments were comparable, but intensity of pain was higher in the surgical group (at rest: 2.5±0.1 vs. 2.0±0.2, during exercise: 4.2±0.1 vs. 3.8±0.2; both p<0.05). Following treatment, surgical patients demonstrated a larger drop in intensity levels of pain (surgery 1.6±0.1, conservative 0.9±0.2, p=0.01) and tightness (surgery 1.4±0.1, conservative 0.4±0.3, p=0.00) during exercise. Success (good or excellent treatment effect) was attained in 42% of the surgical group compared to only 17% in the conservatively treated group (p=0.02). However, previous activity level was achieved in a mere 26% in the surgical treatment group and 35% in the conservative treatment group (p=0.33). A fasciotomy for chronic exertional compartment syndrome in the leg results in significantly decreased levels of pain and tightness and better satisfaction compared to patients who continued a conservative treatment regimen.

Key words

chronic exertional compartment syndrome - fasciotomy - lower extremity - conservative treatment - cohort study


Publication History

Received: 17 March 2020

Accepted: 20 September 2020

Article published online:
11 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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