Int J Sports Med 2008; 29(5): 419-423
DOI: 10.1055/s-2007-965365
Orthopedics & Biomechanics

© Georg Thieme Verlag KG Stuttgart · New York

Chronic Deep Posterior Compartment Syndrome of the Leg in Athletes: Postoperative Results of Fasciotomy

W. J. F. van Zoest1 , A. R. Hoogeveen2 , M. R. M. Scheltinga3 , H. A. Sala1 , J. B. A. van Mourik1 , P. R. G. Brink4
  • 1Orthopaedic Surgery, Máxima Medical Centre, Veldhoven, Netherlands
  • 2Sports Medicine, Máxima Medical Centre, Veldhoven, Netherlands
  • 3Surgery, Máxima Medical Centre, Veldhoven, Netherlands
  • 4Traumatology, University Hospital Maastricht, Maastricht, Netherlands
Further Information

Publication History

accepted after revision April 16, 2007

Publication Date:
13 September 2007 (online)

Abstract

The present study evaluates the efficacy of two treatment regimens in individuals possibly suffering from chronic exercise induced compartment syndrome (CECS) of the deep posterior compartment of the leg. We hypothesised that the current method of fasciotomy of the deep posterior compartment of the leg is a procedure with a limited success rate. Dynamic intra-compartmental pressure measurements were applied to 46 patients that had symptomatology of a posterior CECS. Only those patients that met predefined pressure criteria, the “high-pressure group” (27 patients), were offered surgical treatment in the form of fasciotomy. The other 19 patients, “low-pressure group”, received conservative treatment, consisting of inlays and physiotherapy. In addition, these patients were examined more closely in order to exclude different pathology. Efficacy of both approaches was evaluated by a questionnaire after a mean three-year follow-up. Fifty-two percent of the high-pressure group judged their operation successful, whereas 48 % did not. The majority of the low-pressure group (84 %) was free of symptoms, after conservative treatment as well as following treatment of other pathology. The present study shows that the success rate of patients surgically treated for posterior CECS is relatively low (52 %). The established cut-off points for the compartment pressure to deselect patients for an operation are justified based on the long-term success rate of the low-pressure group.

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M.D. Wart J. F. van Zoest

Orthopaedic Surgery
Máxima Medical Centre

De Run 4600

5504 DB Veldhoven

Netherlands

Phone: + 31 40 88 88 00

Fax: + 31 4 08 88 85 68

Email: wvanzoest@mac.com

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