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1 The effect of fasciotomy for the treatment of chronic exertional compartment syndrome of the lower leg

Introduction This study aims to report the post-surgical objective functional outcome in patients with chronic exertional compartment syndrome (CECS) having undergone primary fasciotomy. Materials and methods Patients who underwent fasciotomy for CECS at our facility between July 2014 and December 2017 with pre-operative data were retrospectively identified. Pre-operatively the patients underwent a treadmill test and the time until they had to stop due to symptoms and/or experienced pain equal to an 8–10 on the VAS scale was recorded. At a minimum of 8 months after surgery the treadmill test was performed again at the same speed and inclination as the pre-surgery test. Pain was then recorded at the exact time they either had to stop or experienced a pain of 8–10 on the vas scale during the pre-surgery test. Results A total of 19 patients were included, with 8 patients (5 F 3 M) in the anterior fasciotomy group (median age 24.73 years) and 11 patients (9 F 3 M) in the posterior fasciotomy group (median age 22.78 years). The anterior fasciotomy group experienced a decrease in VAS from a median of 8 pre-operatively to 1.5 post-operatively (p<0.01). The posterior fasciotomy group experienced a decrease in VAS from a median of 8.25 pre-operatively to 4 post-operatively (p<0.01). Conclusion Fasciotomy significantly decreased pain during activity in patients with anterior and posterior CECS. To our knowledge this is the first study to report an objective measure of the functional outcome following primary fasciotomy for the treatment of CECS.