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Review
. 2017 May;12(3):NP43-NP45.
doi: 10.1177/1558944716668826. Epub 2016 Sep 15.

Chronic Exertional Compartment Syndrome of the Hand: Case Report and Literature Review

C Liam Dwyer  1 , Maximillian C Soong  1 , N George Kasparyan  1
Affiliations
Review

Chronic Exertional Compartment Syndrome of the Hand: Case Report and Literature Review

C Liam Dwyer et al. Hand (N Y). 2017 May.

Abstract

Background: Chronic exertional compartment syndrome (CECS) is characterized by activity-induced pain, swelling, and decreased muscle function due to increased pressure and decreased circulation within a confined muscle compartment. Although well-known to occur in the leg, involvement of the hand has rarely been reported in the literature.

Methods: We present a 44 year old male with CECS involving bilateral thenar and hypothenar compartments. Symptoms were reproduced on exam by driving screws into wood with a screwdriver. Elevated compartment pressures were confirmed with a hand-held digital device which employs a rigid needle that is readily directed to specific compartments.

Results: Selective releases of the thenar and hypothenar compartments were performed under local anesthesia and forearm tourniquet in the ambulatory surgery center. At 3-month follow-up, the patient reported full use of his right hand, including woodworking, with excellent relief of symptoms. At 5 months postoperatively, he underwent identical surgical releases on the contralateral left side, with similar relief.

Conclusions: CECS of the hand is a rare condition. Our case is unique among prior reports with regard to pattern of compartment involvement, as well as provocative maneuvers and compartment testing methods employed. This report should help foster clinical suspicion, facilitate diagnosis, and demonstrate success of targeted surgical treatment.

Keywords: chronic exertional; compartment syndrome; hand; hypothenar; thenar.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The right hand demonstrates well-developed thenar and hypothenar musculature.
Figure 2.
Figure 2.
Swollen hypothenar muscle is revealed during release of tight and thickened fascia.
See this image and copyright information in PMC

References

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