Mangan John J, Rogero Ryan G, Fuchs Daniel J, Raikin Steven M
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania; and.
Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
Clin J Sport Med. 2022 May 1;32(3):272-277. doi: 10.1097/JSM.0000000000000865. Epub 2020 Sep 15.
To evaluate patient-reported outcomes and return to sport after open fasciotomy for lower extremity chronic exertional compartment syndrome (CECS).
Retrospective case series.
Foot and ankle specialty service at a large multisite academic medical center.
All patients undergoing lower extremity fasciotomy for CECS from 2009 to 2017 by one surgeon were eligible. Patients that underwent a fasciotomy for trauma, infection, or an acute pathologic process were excluded. Fifty-nine patients that underwent 63 procedures were included. The average age was 26.6 years, and 35 (59%) patients were women. Thirty-seven patients underwent simultaneous bilateral fasciotomies, 4 had staged bilateral fasciotomies, and 18 underwent unilateral fasciotomy. Four-compartment fasciotomy was performed 15 times.
Retrospective email/telephone follow-up.
Return to sports questionnaire, the Foot and Ankle Ability Measure-Sports subscale, and visual analog scale for pain.
At a mean follow-up of 58.8 months, significant postoperative improvement was seen in patient-reported outcome scores compared with preoperative scores (P < 0.0001). Overall, 55 (93%) patients were able to return to sport, 42 (76%) returned to the same level of sport, and 13 (24%) returned to a lower level of competition. Bivariate regression analysis demonstrated that a higher preoperative body mass index [odds ratio: 0.829 (95% confidence interval: 0.688, 0.999); P = 0.049] was associated with a lower likelihood of return to sport.
This study demonstrates that lower extremity fasciotomy for CECS results in improvement of patient-reported outcomes and a high rate of return to sport.
评估下肢慢性运动性骨筋膜室综合征（CECS）切开减压术后患者报告的结局及恢复运动情况。
回顾性病例系列研究。
一家大型多机构学术医疗中心的足踝专科门诊。
2009年至2017年由同一外科医生为CECS行下肢筋膜切开减压术的所有患者符合纳入标准。因创伤、感染或急性病理过程行筋膜切开减压术的患者被排除。纳入59例行63次手术的患者。平均年龄26.6岁，35例（59%）为女性。37例患者同时行双侧筋膜切开减压术，4例分期行双侧筋膜切开减压术，18例接受单侧筋膜切开减压术。四室筋膜切开减压术进行了15次。
回顾性电子邮件/电话随访。
运动恢复问卷、足踝能力测量-运动分量表及疼痛视觉模拟量表。
平均随访58.8个月，与术前评分相比，患者报告的结局评分术后有显著改善（P < 0.0001）。总体而言，55例（93%）患者能够恢复运动，42例（76%）恢复到相同运动水平，13例（24%）恢复到较低竞争水平。双变量回归分析表明，术前较高的体重指数[比值比：0.829（95%置信区间：0.688，0.999）；P = 0.049]与恢复运动的可能性较低相关。
本研究表明，CECS下肢筋膜切开减压术可改善患者报告的结局，且恢复运动率较高。
