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Flail Chest-II

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A Novel Non-invasive Method for the Detection of Elevated Intra-compartmental Pressures of the Leg

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Published on: May 31, 2019

Four-Compartment Fasciotomy for Chronic Exertional Compartment Syndrome.

Deeya Prakash¹, Giovanna Medina^2,3, Elizabeth Matzkin^3,4

¹Brown University, Providence, Rhode Island, USA.

Video Journal of Sports Medicine

|May 15, 2026

Summary

This case study demonstrates that bilateral 4-compartment fasciotomy is an effective treatment for adolescent females with chronic exertional compartment syndrome (CECS). Further research is needed to understand sex-specific outcomes for female athletes undergoing CECS surgery.

Keywords:

chronic exertional compartment syndrome fasciotomy female athlete lower leg pain return to sport sports medicine

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Published on: January 26, 2024

Area of Science:

Orthopedic Surgery
Sports Medicine
Adolescent Medicine

Background:

Chronic exertional compartment syndrome (CECS) presents as exercise-induced pain that resolves with rest.
Diagnosis often involves elevated intercompartmental pressure during exercise.
Fasciotomy is a primary surgical treatment, but sex-specific outcomes require more study.

Purpose of the Study:

To present a case of a 17-year-old female adolescent with CECS treated with bilateral 4-compartment fasciotomy.
To highlight the surgical technique used for the procedure.
To discuss the patient's return to sport and compare outcomes with existing literature.

Main Methods:

A 17-year-old female with a 2-year history of bilateral calf pain underwent bilateral 4-compartment fasciotomy after conservative treatments failed.
The surgical technique involved limited longitudinal incisions for sequential release of all four compartments in each leg.
Careful nerve identification and protection were emphasized during the procedure.

Main Results:

The patient successfully returned to soccer within 3 months post-surgery and remained asymptomatic.
This outcome contrasts with some literature suggesting lower return-to-sport rates for females compared to males.
Postoperative pain severity was reported as lower in females in some studies.

Conclusions:

Bilateral 4-compartment fasciotomy is an effective surgical option for adolescent females diagnosed with CECS.
Prospective, sex-inclusive research is necessary to address conflicting data on sex-based outcomes in CECS.
Optimizing rehabilitation protocols for female athletes requires further investigation into prognostic factors.