[Chronic compartmental syndrome. a review of 234 patients]

Abstract

Objective: Diagnosis of chronic compartment syndrome of the lower leg, which occurs in a young and athletic population, is often delayed. We studied postoperative outcomes after fasciotomy in patients with compartment syndrome in order to identify specific postoperative complications. Long-term functional outcomes were also evaluated.

Methods: All patients with a diagnosis of chronic exercise-related compartment syndrome of the lower leg who underwent surgery from January 1985 to August 2009 were studied prospectively. The type of compartment and whether surgery was uni or bilateral was recorded. One year after surgery, patients completed a questionnaire to evaluate their functional outcome.

Results: Two hundred and thirty-six compartment procedures were performed in 234 patients. Only one compartment (constantly the superficial posterior compartment) was treated in 56/236 (23.7%) procedures. Two compartments (anterior and lateral) were involved in 90/236 procedures (38.1%). Three compartments (anterolateral and superficial posterior) were noted in 74/236 procedures (31.4%) and four compartments (anterolateral and superficial and deep posterior) were described in 6.8%. Involvement of the deep posterior compartment was always associated with another compartment. Surgery was bilateral in 70% of patients. The questionnaire response rate was 65%. The success rate of fasciotomy was 68.4% and a significant improvement was reported by 23.9% of responders; outcome was unsatisfactory for 7.7%.

Conclusions: The diagnostic criteria used to confirm chronic exercise-related compartment syndrome of the lower leg were based on the compartment pressure measurement after exercise. In this study, all patients underwent fasciotomy. The surgical technique was standardized. Outcomes have been satisfactory with few surgical complications.