Department of Orthopedic Surgery, Tufts Medical Center, Boston, Massachusetts.
Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts.
Sports Health. 2020 May/Jun;12(3):304-309. doi: 10.1177/1941738120907897. Epub 2020 Mar 12.
Chronic exertional compartment syndrome (CECS) is primarily seen in running athletes. Previous outcomes of surgical treatment with fasciotomy have suggested moderate pain relief, but evidence is lacking regarding postoperative return to running.
Running athletes with limiting symptoms of CECS will show high rates of return to running after fasciotomy.
Case series.
Level 4.
Running athletes treated with fasciotomy for CECS at a single institution were identified using a surgical database and asked to complete a questionnaire designed to assess postoperative pain, activity level, return to running, running distances, overall satisfaction, and rate of revision fasciotomy.
A total of 43 runners met the inclusion criteria, and 32 runners completed outcomes questionnaires at a mean postoperative follow-up of 66 months. In total, 27 of these 32 patients (84%) returned to sport(s) after fasciotomy. However, 9 (28%) of these patients pursued nonrunning sports, 5 (16%) due to recurrent pain with running. Of the 18 patients who returned to running sports (56%), the mean weekly running distance decreased postoperatively. Recurrence of symptoms was reported in 6 patients (19%), 4 of whom had returned to running and 2 of whom had been unable to return to sports. All of these 6 patients elected to undergo revision fasciotomy surgery. Twenty-five (78.1%) patients reported being satisfied with their procedure. In the overall cohort, the mean visual analog scale scores for pain during activities/sports decreased from 7.9 preoperatively to 1.7 postoperatively.
Fasciotomy for CECS in runners may provide significant improvement in pain and satisfaction in over three-quarters of patients and return to sports in 84% of patients. However, only 56% returned to competitive running activity, with a subset (19%) developing recurrent symptoms resulting in revision surgery.
Fasciotomy has been shown to decrease pain in most patients with CECS. This study provides outcomes in running athletes after fasciotomy for CECS with regard to return to sports, maintenance of sports performance, and rates of revision surgery.
慢性运动性间隔综合征（CECS）主要见于跑步运动员。先前的筋膜切开术手术治疗结果表明疼痛有一定程度的缓解，但缺乏术后恢复跑步运动的相关证据。
患有 CECS 且症状受限的跑步运动员在接受筋膜切开术后，将会有很高的恢复跑步运动的比例。
病例系列。
4 级。
通过手术数据库确定在一家医疗机构接受筋膜切开术治疗 CECS 的跑步运动员，并要求他们填写一份问卷，旨在评估术后疼痛、活动水平、恢复跑步运动、跑步距离、整体满意度和筋膜切开术翻修率。
共有 43 名跑步运动员符合纳入标准，其中 32 名运动员在平均 66 个月的术后随访时完成了问卷调查。在这些 32 名患者中，共有 27 名（84%）在筋膜切开术后恢复了运动。然而，其中 9 名（28%）选择了非跑步运动，5 名（16%）是因为跑步时疼痛复发。在 18 名恢复跑步运动的患者中（56%），术后每周跑步距离减少。6 名患者（19%）报告出现症状复发，其中 4 名已经恢复跑步运动，2 名无法恢复运动。这 6 名患者均选择接受筋膜切开术翻修手术。25 名（78.1%）患者对手术过程表示满意。在总体队列中，活动/运动时的视觉模拟评分（VAS）从术前的 7.9 分降至术后的 1.7 分。
对于跑步运动员的 CECS，筋膜切开术可能会使超过四分之三的患者的疼痛和满意度显著改善，并使 84%的患者恢复运动。然而，只有 56%的患者恢复了竞技性跑步活动，其中一部分（19%）出现症状复发，需要进行翻修手术。
筋膜切开术已被证明可减轻大多数 CECS 患者的疼痛。本研究提供了 CECS 患者接受筋膜切开术后恢复运动、维持运动表现和翻修手术率的结果。
