Edmundsson David, Toolanen Göran, Sojka Peter
Department of Surgery and Perioperative Science (Orthopaedics), Umeå University, Umeå, SE-901 85, Sweden.
Acta Orthop. 2007 Feb;78(1):136-42. doi: 10.1080/17453670610013547.
Chronic exertional compartment syndrome is most often reported in young and physically active people.
We studied 73 consecutive patients (mean age 39 (16-77) years, 45 women) with a history of exercise-induced pain and suspicion of chronic exertional compartment syndrome (CECS) of the lower leg--clinically, radiographically and with intramuscular pressure measurements.
Intramuscular pressure increased with reproduction of symptoms and fulfilled the criteria for diagnosis of CECS in 36 patients (mean age 36 (16-65) years, 22 women), with engagement of 66 anterior, 2 lateral and 7 posterior muscle compartments in 72 legs. The patients with CECS of the lower leg were divided into 4 etiological groups: 18 with overuse, 10 with earlier trauma, 4 insulin-treated diabetics, and 4 others. Two-thirds of the patients had pain during walking. The outcome after fasciotomy was excellent or good in 41/57 of the legs.
CECS of the lower leg probably has a multifactorial etiology and is more common in sedentary individuals than has been recognized previously. Fasciotomy appears to be beneficial in these cases also.
慢性运动性骨筋膜室综合征最常发生于年轻且有运动习惯的人群。
我们连续研究了73例有运动诱发疼痛病史且怀疑患有小腿慢性运动性骨筋膜室综合征(CECS)的患者(平均年龄39(16 - 77)岁,45名女性),通过临床、影像学及肌内压力测量进行研究。
36例患者(平均年龄36(16 - 65)岁,22名女性)的肌内压力随症状再现而升高,符合CECS诊断标准,72条腿中有66个前侧、2个外侧和7个后侧肌骨筋膜室受累。小腿CECS患者分为4个病因组:18例过度使用,10例既往有创伤史,4例接受胰岛素治疗的糖尿病患者,4例其他情况。三分之二的患者行走时疼痛。57条腿中有41条在筋膜切开术后效果优良。
小腿CECS可能有多种病因,在久坐人群中比之前认识到的更为常见。筋膜切开术在这些病例中似乎也有益。