Fasciotomy and Occupational Separation among US Service Members with Lower Extremity Chronic Exertional Compartment...

Area of Science:

• Orthopedics
• Military Medicine
• Occupational Health

Background:

• Lower extremity chronic exertional compartment syndrome (LE-CECS) is a condition that can impede physical activity.
• Fasciotomy is a surgical treatment option for LE-CECS.
• The impact of LE-CECS and its surgical treatment on military occupational outcomes is not well-documented.

Purpose of the Study:

• To investigate the association between LE-CECS diagnoses and fasciotomy procedures with military service separation.
• To identify if LE-CECS and subsequent fasciotomy predict discharge from active duty in US service members.

Main Methods:

• A retrospective cohort study was conducted using data from 1,103,417 US service members who entered service between 2011 and 2017.
• Sex-specific multivariable regression models were used to analyze separation outcomes.
• Data on LE-CECS diagnoses and fasciotomy procedures were correlated with service separation statuses.

Main Results:

• LE-CECS diagnosis was linked to a 474% increased medical separation risk in men and a 282% increase in women.
• Among LE-CECS patients, men undergoing anterior/lateral fasciotomy had a 57% higher nonmedical separation risk; women had a 119% increase.
• Men with LE-CECS and posterior procedures showed increased nonmedical (47%) and medical (36-78%) separation risks.

Conclusions:

• LE-CECS is associated with a significantly higher risk of military service discharge.
• Fasciotomy for LE-CECS did not demonstrate a positive effect on career longevity in service members.
• Fasciotomy may serve as an indicator for more severe LE-CECS cases, potentially predicting poorer occupational outcomes.