How To Diagnose And Treat Chronic Exertional Compartment Syndrome

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Author(s): 
Robert J. Duggan, DPM, Alan A. MacGill, DPM, Christopher L. Reeves, DPM, and Scott P. Goldstein, DPM

   There a few different methods to diagnose CECS in the lower leg. Sphygmomanometer testing, magnetic resonance imaging and near-infrared spectroscopy are reasonable non-invasive methods for identifying this pathology, although sensitivity and specificity vary. The gold standard today remains intracompartmental pressure testing following a brief period of exertion.

   Surgical treatment for CECS remains the treatment of choice for patients with elevated intracompartmental pressures.4 Today surgeons perform compartment decompression either by open fasciotomy or by subcutaneous fascial division.3

   Endoscopically assisted release improves visualization and minimizes the risk of incomplete compartment decompression and inadvertent neurovascular injuries, subsequently improving patient outcomes.1,3 Endoscopically assisted fasciotomy for CECS in the anterior and lateral compartments of the lower leg is a safe and reliable technique with excellent outcomes and patient satisfaction.6,13

Dr. Duggan is an Attending Physician with the Florida Hospital East Orlando Residency Training Program in Orlando, Fla. He is a Fellow of the American College of Foot and Ankle Surgeons.
Dr. MacGill is the Chief Resident of Foot and Ankle Surgery at Florida Hospital East Orlando.

Dr. Reeves is an Attending Physician with the Florida Hospital East Orlando Residency Training Program. He is a Fellow of the American College of Foot and Ankle Surgeons and a Diplomate of the American Board of Podiatric Surgery.

Dr. Goldstein is an Associate of the American College of Foot and Ankle Surgeons. He practices in Ocala, Fla.

Dr. Richie is an Adjunct Associate Professor in the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt College. He is a Past President of the American Academy of Podiatric Sports Medicine.

For further reading, see “How To Detect And Treat Chronic Compartment Syndrome” in the December 2002 issue of Podiatry Today.

To access the archives or get information on reprints, visit www.podiatrytoday.com.




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