How To Diagnose And Treat Chronic Exertional Compartment Syndrome

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

   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.




References:

1. Detmer DE, Sharpe K, et al. Chronic compartment syndrome: Diagnosis, management, and outcomes. Am J Sports Med 1985; 13(3):162-169.
2. Gebauer A, et al. Chronic exercise-induced leg pain in an athlete successfully treated with sympathetic block. Am J Sports Med 2005; 33(10):1575-1578.
3. Leversedge FJ, Casey PJ, Seiler JG, et al. Endoscopically assisted fasciotomy: Description of technique and in-vitro assessment of lower-leg compartment decompression. Am J Sports Med 2002; 30(2):272-278.
4. Mavor GE. The anterior tibial syndrome. J Bone Joint Surg Br 1956; 38(2):513-517.
5. Cohen MM. How to detect and treat chronic compartment syndrome. Podiatry Today 2002; 15(12):40-49.
6. Stein DA, Sennett BJ. One-portal endoscopically assisted fasciotomy for exertional compartment syndrome. J Arthro and Rel Surg 2005; 21(1):108-112.
7. Howard JL, Mohtadi NG, Wiley JP. Evaluation of outcomes in patients following surgical treatment of chronic exertional compartment syndrome in the leg. Clin J Sports Med 2000; 10(3):176-184.
8. Bourne RB, Robrabeck CH. Compartment syndromes of the lower leg. Clin Ortho Rel Res 1989; 240:97-104.
9. Verleisdonk EJ, Schmitz RF, van der Werken C. Long-term results of fasciotomy of the anterior compartment in patients with exercise-induced pain in the lower leg. Int J Sports Med 2004; 25(3):224-229.
10. Hutchinson MR, Bederka B, Kopplin M. Anatomic structures at risk during minimal-incision endoscopically assisted fascial compartment release in the leg. Am J Sports Med 2003; 31(5):764-769.
11. Tzortziou V, Maffulli N, Padhiar N. Diagnosis and management of chronic exertional compartment syndrome in the United Kingdom. Clin J Sport Med 2006; 16(3):209-213.
12. Van den Brand JG, Nelson T, et al. The diagnostic value of intracompartmental pressure measurement, magnetic resonance imaging, and near-infrared spectroscopy in chronic exertional compartment syndrome. Am J Sports Med 2005; 33(5):699-704.
13. Schepsis AA, Fitzgerald M, Nicoletta R. Revision surgery for exertional anterior compartment syndrome of the lower leg. Am J Sports Med 2005; 33(7):1040-1047.

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