Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Ortopedmottagningen Molndal, 431 80, Molndal, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1332-1339. doi: 10.1007/s00167-020-06143-w. Epub 2020 Jul 8.
To investigate distributions and identify possible differences in intramuscular pressure (IMP) values at 1 min post-exercise between the four muscle compartments of the lower leg, in patients with exertional leg pain with or without chronic exertional compartment syndrome (CECS).
A consecutive series of patients seeking orthopaedic consultation for exertional leg pain underwent IMP measurements between 2009 and 2018. The diagnosis of CECS was confirmed (n = 442) or ruled out (n = 422), based on the patient's history, clinical examination, and IMP measurements.
The median (range) 1 min post-exercise IMP values in affected compartments in the patients diagnosed with CECS were 33 (25-53) mmHg (deep posterior), 35 (27-54) mmHg (superficial posterior), 40 (26-106) mmHg (lateral), and 47 (24-120) mmHg (anterior). In patients with no CECS, the median (range) 1 min post-exercise IMP values in the compartments were 12 (2-28) mmHg (deep posterior), 12 (2-27) mmHg (superficial posterior), 14 (2-26) mmHg (lateral), and 18 (4-34) mmHg (anterior). The IMP was significantly lower in the lateral and both posterior compartments than in the anterior compartment in both patients diagnosed with CECS and patients without CECS.
The study demonstrates significantly lower IMP values in the posterior and lateral compartments compared to the anterior compartments. These findings suggest a lowering of the IMP 1 min post-exercise cut-off value for diagnosing CECS in the lateral and both posterior compartments, which may lead to improved treatment of patients with suspected CECS in the lower leg.
Level II.
探讨运动后 1 分钟小腿四个肌肉间隔内的肌肉内压（IMP）值的分布，并确定其在伴有或不伴有慢性运动性间隔综合征（CECS）的运动性小腿痛患者中的差异。
2009 年至 2018 年间，连续系列因运动性小腿痛而寻求矫形会诊的患者接受了 IMP 测量。根据患者的病史、临床检查和 IMP 测量结果，确定（n=442）或排除（n=422） CECS 的诊断。
在被诊断为 CECS 的患者中，受累间隔的运动后 1 分钟 IMP 值中位数（范围）分别为 33（25-53）mmHg（深部后间隔）、35（27-54）mmHg（浅部后间隔）、40（26-106）mmHg（外侧间隔）和 47（24-120）mmHg（前间隔）。在无 CECS 的患者中，间隔的运动后 1 分钟 IMP 值中位数（范围）分别为 12（2-28）mmHg（深部后间隔）、12（2-27）mmHg（浅部后间隔）、14（2-26）mmHg（外侧间隔）和 18（4-34）mmHg（前间隔）。在患有 CECS 和无 CECS 的患者中，IMP 值在外侧和两个后间隔中均显著低于前间隔。
本研究表明，与前间隔相比，后间隔和外侧间隔的 IMP 值明显更低。这些发现提示，在外侧和两个后间隔中，CECS 的诊断运动后 1 分钟 IMP 值的截断值可能会降低，这可能会改善对疑似 CECS 的小腿患者的治疗。
二级。
