Division of Orthopedics, Department of Surgery and Perioperative Science, Umeå University Hospital, Umeå, Sweden.
Laboratory of Muscle Biology, Department of Integrative Medical Biology, Umeå University, 901 87, Umeå, Sweden.
Muscle Nerve. 2018 Feb;57(2):229-239. doi: 10.1002/mus.25715. Epub 2017 Jun 22.
Muscle changes in patients with diabetes and lower leg pain due to chronic exertional compartment syndrome (CECS) were investigated before and after fasciotomy.
The tibialis anterior muscle was analyzed with histochemical and morphological techniques in 7 patients with diabetes and CECS before fasciotomy and in 5 of them 1 year after fasciotomy. Nondiabetic patients with CECS and healthy participants served as references.
Before treatment, walking distance until occurrence of pain was limited (<0.2 km). Intramuscular pressure was significantly higher than in reference participants. Muscle analysis showed changes pathognomonic for neuropathy and myopathy and a restricted capillary network, with significantly more severe changes in the muscles of patients with diabetes than in the muscles of nondiabetic patients. Treatment with fasciotomy improved clinical signs, increased walking ability, and reduced muscle abnormalities, but muscle capillarization remained low.
Patients with diabetes and CECS have distinct pathological changes in affected muscles. Pressure-relieving fasciotomy triggers a regenerative response in the muscle tissue but not in the capillary bed. Muscle Nerve 57: 229-239, 2018.
研究了糖尿病患者小腿疼痛伴慢性运动性间隔综合征（CECS）患者筋膜切开术前和术后的肌肉变化。
对 7 例糖尿病合并 CECS 患者的胫骨前肌进行组织化学和形态学分析，其中 5 例患者在筋膜切开术后 1 年进行了分析。非糖尿病 CECS 患者和健康参与者作为参考。
治疗前，疼痛发生前的步行距离有限（<0.2 公里）。肌内压明显高于参考组。肌肉分析显示出神经病和肌病的特征性改变以及毛细血管网络受限，糖尿病患者的肌肉变化明显比非糖尿病患者的肌肉变化更严重。筋膜切开术治疗改善了临床症状，提高了步行能力，并减少了肌肉异常，但肌肉毛细血管化仍然较低。
糖尿病合并 CECS 的患者肌肉有明显的病理变化。减压筋膜切开术可触发肌肉组织的再生反应，但不会触发毛细血管床的再生反应。肌肉神经 57: 229-239, 2018.
