The Outcomes of Single-Portal Endoscopic Fasciotomy for Chronic Exertional Compartment Syndrome of the Forearm

Chronic exertional compartment syndrome (CECS) of the forearm is a rare and underdiagnosed condition that mainly affects young athletes. Minimally invasive endoscopic surgical treatment has been shown to reduce complication rates and allow for an expedited return to activity. Evidence on the outcomes of single-portal endoscopic fasciotomy for forearm CECS remains limited. The aim of this study was to describe the results of single-portal endoscopic-assisted fasciotomy in treating forearm CECS.

A total of 17 patients (21 forearms) diagnosed with forearm CECS and treated with single-portal endoscopic-assisted fasciotomy were included in this study. Intracompartmental pressure was preoperatively measured at rest, on exertion, and at 5 min postexertion. Additionally, pain intensity and physical function were evaluated using the visual analog scale (VAS) and the Disability of Arm, Shoulder, and Hand (DASH) questionnaire, respectively, before surgery and 4 weeks after surgery.

Preoperative assessments revealed a mean intracompartmental pressure of 15.7 ± 1.5 mmHg at rest, 77.7 ± 3.8 mmHg on exertion, and 22.9 ± 2.3 mmHg at 5 min postexertion. The mean preoperative VAS score was 7.6 ± 1.1, which dropped to 0.1 ± 0.35 after surgery. The mean DASH score was 29.8 ± 3.0 preoperatively and 4.6 ± 2.4 postoperatively. Both VAS and DASH scores were significantly lower after surgery (paired t test, p < 0.001). No major adverse effects were reported. Patients returned to light cycling at an average of 10 ± 3.8 days and resumed usual daily activities within 18.2 ± 1.9 days on average.

Endoscopic compartment decompression through a single port proved to be an effective and safe surgical treatment technique in patients with forearm CECS, thus deserving serious consideration as a replacement for classic fasciotomy.

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