Chandwani Deepak, Varacallo Matthew A.
Penn Highlands Healthcare System
Exertional compartment syndrome is often a diagnosis of exclusion and occurs secondary to increased pressures in a muscular compartment, with resultant ischemia manifesting most commonly as pain. There are two distinct forms of exertional compartment syndrome, acute and chronic types. Chronic exertional compartment syndrome (CECS) occurs in the setting of recurrent, reversible ischemic episodes following the cessation of activity resulting in the predictable decrease in fascial compartment pressures. Although benign, the refractory nature of CECS often results in a substantial portion of patients ultimately electing to proceed with fasciotomies. Acute exertional compartment syndrome (AECS) is a rare entity that, unfortunately, its diagnosis is often delayed. Just as in acute compartment syndrome (ACS), the diagnosis implies a surgical emergency requiring fasciotomies to help mitigate the risks of ensuing irreversible muscle ischemia and neurovascular injury, which can occur after just a few hours alone. ECS typically occurs in the lower leg but can also occur in other areas like the forearm, thigh, or hand. The article provides an overview of the hallmarks and diagnostic considerations surrounding both forms of ECS, including the importance of clinicians maintaining a high index of suspicion to avoid delays in diagnosis.
运动性骨筋膜室综合征通常是一种排除性诊断，继发于肌肉骨筋膜室内压力升高，由此产生的缺血最常见的表现为疼痛。运动性骨筋膜室综合征有两种不同形式，即急性和慢性类型。慢性运动性骨筋膜室综合征（CECS）发生在活动停止后反复出现的、可逆的缺血发作的情况下，导致筋膜室压力可预测性降低。尽管CECS是良性的，但其难治性往往导致相当一部分患者最终选择进行筋膜切开术。急性运动性骨筋膜室综合征（AECS）是一种罕见的疾病，不幸的是，其诊断往往被延迟。与急性骨筋膜室综合征（ACS）一样，该诊断意味着需要进行筋膜切开术的外科急症，以帮助降低随后可能出现的不可逆肌肉缺血和神经血管损伤的风险，这种损伤可能在短短几个小时后就会发生。运动性骨筋膜室综合征通常发生在小腿，但也可能发生在其他部位，如前臂、大腿或手部。本文概述了两种形式的运动性骨筋膜室综合征的特点和诊断注意事项，包括临床医生保持高度怀疑指数以避免诊断延迟的重要性。
