Hutchinson Mark R, Bederka Bryce, Kopplin Matthew
Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, USA.
Am J Sports Med. 2003 Sep-Oct;31(5):764-9. doi: 10.1177/03635465030310052101.
Although minimal-incision surgical techniques are recommended for treatment of chronic exertional compartment syndrome of the leg, which is an increasing problem among endurance athletes, there is little information about anatomic correlation with structures at risk.
Fascial releases performed with endoscopic assistance are safer than the percutaneous method.
Controlled laboratory study.
Ten endoscopically assisted and six percutaneous fascial releases were performed on 16 human cadaveric lower limbs. Formal dissection documented length of release and proximity of structures at risk.
Endoscopically assisted fascial release led to reduced risk of superficial peroneal nerve injury compared with a blind percutaneous release through a 2- to 3-cm incision. Both techniques had unacceptable rates of saphenous vein injury (30% to 100%), and releases performed percutaneously had greater length.
Risk of superficial peroneal nerve injury was less with single-incision endoscopically assisted fascial release. Risk of injury to the saphenous vein from either technique appeared to be unacceptable.
Single-incision endoscopically assisted fascial release of the anterior and lateral compartments may be a useful technique with low risk of peroneal nerve injury. Clinical studies will confirm whether this technique proves safer or more effective than those currently used for chronic exertional compartment syndrome of the leg.
尽管对于腿部慢性运动性骨筋膜室综合征（这在耐力运动员中是一个日益严重的问题）的治疗推荐采用微创外科技术，但关于与危险结构的解剖学相关性的信息却很少。
在内镜辅助下进行的筋膜松解术比经皮方法更安全。
对照实验室研究。
在16具人类尸体下肢上进行了10例内镜辅助筋膜松解术和6例经皮筋膜松解术。正式解剖记录了松解长度和危险结构的接近程度。
与通过2至3厘米切口进行的盲法经皮松解相比，内镜辅助筋膜松解术导致腓浅神经损伤的风险降低。两种技术的大隐静脉损伤发生率都不可接受（30%至100%），且经皮松解的长度更长。
单切口内镜辅助筋膜松解术导致腓浅神经损伤的风险较小。两种技术导致大隐静脉损伤的风险似乎都不可接受。
单切口内镜辅助下对小腿前侧和外侧骨筋膜室进行筋膜松解术可能是一种有用的技术，腓总神经损伤风险较低。临床研究将证实该技术是否比目前用于腿部慢性运动性骨筋膜室综合征的技术更安全或更有效。
