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Chronic compartment syndrome. An unusual cause for claudication
W Turnipseed1, D E Detmer, F Girdley
1Department of Surgery, University of Wisconsin Hospital and Clinics, Madison 53792.
Annals of Surgery
|October 1, 1989
Summary
Chronic Compartment Syndrome (CCS) in athletes requires surgical release, as rest and medication are ineffective. Open fasciectomy shows better outcomes than subcutaneous fasciotomy, with fewer complications and recurrences.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanics
Background:
- Chronic Compartment Syndrome (CCS) is an overuse injury common in athletes, particularly runners.
- Symptoms include claudication, tightness, and paresthesia, unresponsive to conservative treatments like rest or anti-inflammatories.
- Diagnosis is confirmed by elevated compartment pressures exceeding 20 mmHg.
Purpose of the Study:
- To compare the efficacy and outcomes of two surgical treatments for CCS: subcutaneous fasciotomy and open fasciectomy.
- To evaluate complication rates and recurrence of CCS following each surgical procedure.
Main Methods:
- A retrospective study of 209 patients surgically treated for CCS.
- Group I: 100 patients underwent subcutaneous fasciotomy.
- Group II: 109 patients underwent open fasciectomy. Procedures were typically ambulatory under local anesthesia.
Main Results:
- Open fasciectomy resulted in fewer early postoperative wound complications (6% vs. 11% for subcutaneous fasciotomy).
- Open fasciectomy demonstrated significantly fewer late recurrences of CCS (2% vs. 11% for subcutaneous fasciotomy).
Conclusions:
- Surgical compartment release is the only effective treatment for Chronic Compartment Syndrome.
- Open fasciectomy is associated with superior outcomes compared to subcutaneous fasciotomy, including reduced complications and recurrence rates.