Abstract
This prospective study aims to describe the results of fasciotomy in patients with
exercise-induced pain in the lower leg with suspected (chronic) exertional compartment
syndrome. The diagnosis of (chronic) exertional compartment syndrome was made if pain
in the lateral side of the lower leg after a standard physical load was accompanied
by elevated tissue pressures in the anterior muscle compartment. Tissue measurements
were performed in 114 patients. In 56 patients (106 compartments) increased tissue
pressure was found (> 50 mmHg measured immediately after exercise, or > 30 mmHg if
the pressure before exercise > 20 mmHg, or if the pressure five minutes after exercise
is still > 30mmHg). Two years after fasciotomy, (remaining) complaints were evaluated
on the basis of a questionnaire: 87 % of the patients had significant reduction in
complaints. Patients who were not found to have increased tissue pressure were also
asked to report developments through the questionnaire. In 18 patients a fasciotomy
was performed on the basis of the typical history, despite normal or slightly increased
intramuscular pressures. Twelve of these patients (24 compartments) were asymptomatic
after surgery. Fasciotomy in patients with a (chronic) exercise-induced compartment
syndrome in the anterior compartment of the lower leg, based on our criteria, gave
a marked reduction in symptoms in 87 % of the patients. Further research has to be
done for the minimum tissue pressures above which fasciotomy may be successful in
terms of reducing complaints.
Key words
Elevated pressure compartment - fasciotomy
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E. J. M. M. Verleisdonk
Department of Surgery · University Medical Centre Utrecht
Heidelberglaan 100 · 3508 AB Utrecht · The Netherlands
Phone: 31 302506968
Email: E.J.M.M.Verleisdonk@chir.azu.nl
