Alrijne Hospital Leiderdorp, Leiderdorp, The Netherlands.
Alrijne Hospital Leiderdorp, Leiderdorp, The Netherlands
BMJ Mil Health. 2021 Dec;167(6):387-392. doi: 10.1136/jramc-2019-001290. Epub 2020 Feb 3.
Exercise-related leg pain (ERLP) may be caused by chronic exertional compartment syndrome (CECS), occurring mainly in athletes and military recruits. In military populations, the effectiveness of surgical treatment in CECS is debated. The purpose of this study is to assess the outcome of surgical treatment for CECS in Alrijne Hospital (the Netherlands), a civilian hospital with supraregional referral function.
A historic cohort study was performed on patients with ERLP who were suspected for CECS and were referred for intracompartmental pressure measurement (ICPM) from 2013 to 2017 (n=160). Patient demographics, ICPM and survey response were analysed.
The mean delay before visitation was 29.0±30.3 months. When comparing surgical-treated patients with CECS with conservative-treated patients with ERLP, surgical-treated patients were more satisfied, reported better recovery towards former level of performance (2.8±2.0 vs 3.9±1.7 and 2.5±1.6 vs 3.2±1.4 on a 7-point Likert scale, respectively) and better subjective injury status (79.3±22.6 vs 63.5±27.4 using the Single Assessment Numeric Evaluation score). Treatment satisfaction was 75.0% in surgical-treated CECS versus 51.4% in conservative-treated ERLP.
Civilian patients report improved functional outcomes after fasciotomy for CECS. Future research should focus on non-invasive diagnostic options and methods to determine which treatment is the most appropriate for each individual patient.
运动相关性腿部疼痛(ERLP)可能由慢性运动性筋膜室综合征(CECS)引起,主要发生在运动员和新兵中。在军事人群中,CECS 的手术治疗效果存在争议。本研究旨在评估 Alrijne 医院(荷兰)手术治疗 CECS 的效果,该医院为具有区域转诊功能的平民医院。
对 2013 年至 2017 年间因疑似 CECS 而行 ICPM 检查的 ERLP 患者(n=160)进行了一项历史性队列研究。分析了患者的人口统计学资料、ICPM 和调查应答。
就诊前的平均延迟时间为 29.0±30.3 个月。与接受保守治疗的 ERLP 患者相比,接受手术治疗的 CECS 患者更满意,报告的恢复情况更好(7 分制下分别为 2.8±2.0 比 3.9±1.7 和 2.5±1.6 比 3.2±1.4),主观损伤状况更好(单评估数字评估评分分别为 79.3±22.6 比 63.5±27.4)。手术治疗 CECS 的治疗满意度为 75.0%,而保守治疗 ERLP 的治疗满意度为 51.4%。
平民患者在接受 CECS 筋膜切开术后报告功能改善。未来的研究应侧重于非侵入性诊断选择和方法,以确定哪种治疗方法最适合每个患者。