Two-Compartment or 4-Compartment Fasciotomy for Lower Leg Chronic Exertional Compartment Syndrome: A Systematic...

Area of Science:

• Orthopedics
• Sports Medicine
• Surgical Outcomes

Background:

• Lower leg chronic exertional compartment syndrome (CECS) causes exercise-related pain, impairing patients.
• Fasciotomy is the standard surgical treatment for CECS.

Purpose of the Study:

• To systematically review and compare patient-reported outcomes of 2-compartment versus 4-compartment fasciotomy for CECS.

Main Methods:

• Systematic review of controlled clinical trials, cohort studies, and case series.
• Searched PubMed, EMBASE, and Cochrane databases until May 31, 2021.
• Qualitative synthesis of results, with risk of bias and evidence level assessment.

Main Results:

• Seven studies with 194 participants were included, all showing a high risk of bias.
• Both 2- and 4-compartment fasciotomies demonstrated comparable rates of return to activity (90%-100% vs. 50%-100%) and return to previous activity (82%-100% vs. 50%-100%).
• Satisfaction rates and residual symptoms were similar between the two surgical approaches, though one study favored 4-compartment fasciotomy for activity scores.

Conclusions:

• 2-compartment and 4-compartment fasciotomies appear equally successful for treating lower leg CECS.
• Methodological limitations, including small sample sizes and heterogeneity, necessitate cautious interpretation of findings.