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[Exertional compartment syndrome]
J Lecocq1, M E Isner-Horobeti, A Dupeyron
1Service de médecine physique et de réadaptation, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France. jehan.lecocq@chru-strasbourg.fr
Summary
Chronic exertional compartment syndrome causes exertion-related pain due to increased intramuscular pressure. Further research is needed to standardize diagnosis and clarify treatment outcomes for this condition.
Area of Science:
- Sports Medicine
- Orthopedics
- Physiology
Background:
- Chronic exertional compartment syndrome (CECS) is a condition characterized by pain during physical activity that resolves with rest.
- It involves an excessive increase in intramuscular pressure within specific compartments of the limbs.
- The exact pathophysiological mechanisms underlying CECS are not fully understood.
Purpose of the Study:
- To conduct a comprehensive literature review on chronic exertional compartment syndrome.
- To summarize current knowledge regarding its diagnosis, pathophysiology, and treatment.
Main Methods:
- A literature search was performed using Medline.
- Keywords included: compartment syndrome, exertional, chronic, pressure, and fasciotomy.
Main Results:
- CECS presents with exertional pain and elevated intramuscular pressure.
- Intramuscular pressure measurement is the gold standard but lacks standardization.
- Noninvasive diagnostic methods (MRI, SPECT, NIRS) have shown limited diagnostic value.
- Potential pathophysiological factors include muscle hypertrophy, fascial changes, venous return issues, and micro-injuries.
- Treatment options involve activity modification or fasciotomy, with endoscopic-assisted fasciotomy showing promise.
Conclusions:
- Further research is essential to elucidate the physiopathology of CECS.
- Standardization of intramuscular pressure testing and evaluation of pressure thresholds are required.
- Noninvasive diagnostic tools need further assessment.
- Long-term outcomes of fasciotomy require more investigation.