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Updated: Jun 6, 2025

A Novel Non-invasive Method for the Detection of Elevated Intra-compartmental Pressures of the Leg
Published on: May 31, 2019
Fasciotomy for Chronic Exertional Compartment Syndrome of the Deep Posterior Lower Leg Compartment: A Prospective
Chris van den Heuvel-Weiss1,2, Sari Goossens1, Loes Janssen1
1Department of Surgery, Máxima MC, Veldhoven, The Netherlands.
Objective:
Patients with lower leg deep posterior chronic exertional compartment syndrome (dp-CECS) experience exercise-induced calf pain and tightness. Retrospective studies suggest that outcome after a fasciotomy is suboptimal. This prospective case series determined success rates of a fasciotomy and identified factors predicting outcome.
Design:
Severity and intensity of pain and tightness were scored at baseline (BL) and 3 and 12 months postoperatively (follow-up [FU]3, FU12). Outcome measures were symptoms, return to sports, and patient-reported success.
Patients:
Data of patients with dp-CECS (n = 74, 51% males, age 28 ± 12 years) operated between 2013 and 2022 in a single center were analyzed.
Results:
Pain scores during rest and during exercise were greatly attenuated (rest BL: 8 ± 1, FU3: 4 ± 1, FU12: 3 ± 0; exercise BL: 20 ± 1, FU3: 8 ± 1, FU12: 8 ± 1; both P < 0.001). At FU3, rates of success and return to sports were 56% and 63%, respectively. At FU12, success was maintained in 48% and 80% had returned to sports. Length of symptom duration and not opening the flexor hallucis compartment were related to a lower chance of return to sports ( P < 0.05).
Conclusions:
Outcome after a fasciotomy for lower leg dp-CECS is successful in approximately half of patients. Long duration of symptoms and not opening the flexor hallucis compartment are risk factors for failure.

