Rothman Orthopaedic Institute, Philadelphia, Pennsylvania.
Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Sports Health. 2021 Jul-Aug;13(4):396-401. doi: 10.1177/1941738120984109. Epub 2021 Feb 9.
Previous studies have demonstrated the effectiveness of lower extremity fasciotomies in treating chronic exertional compartment syndrome (CECS). However, not all patients have demonstrated the same level of symptom improvement.
Specific patient variables will lead to enhanced functional improvement after fasciotomy for CECS of the lower extremity.
Case series.
Level 4.
A review of patients undergoing fasciotomy of the lower extremity for treatment of CECS by a single surgeon from 2009 to 2017 was performed. Pre- and postoperative measures of Foot and Ankle Ability Measure-Sports subscale (FAAM-Sports), FAAM-Sports Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain during sporting activities were collected at a minimum of 12 months postoperatively. The primary outcomes of change in FAAM-Sports, FAAM-Sports SANE, and VAS during sporting activities were calculated by taking the difference of post- and preoperative scores. Generalized multiple linear regression analyses was performed to determine independent predictors of functional and pain improvement.
A total of 61 patients (58% response rate) who underwent 65 procedures were included in this study, with postoperative outcome measures obtained at mean duration of 57.9 months (range, 12-115 months) after surgery. Patients had a mean ± SD improvement in FAAM-Sports of 40.4 ± 22.3 points ( < 0.001), improvement in FAAM-Sports SANE of 57.3 ± 31.6 points ( < 0.001), and reduction of VAS pain of 56.4 ± 31.8 points ( < 0.001). Multiple linear regression analysis revealed deep posterior compartment involvement, younger age, a history of depression, and male sex to be significant independent predictors of enhanced improvement after fasciotomy.
Fasciotomy is an effective treatment of CECS, with our study identifying certain patient variables leading to greater functional improvement.
Male patients, younger patients, patients with depression, and patients with deep posterior compartment involvement may serve to benefit more with fasciotomies for treatment of CECS.
先前的研究已经证明了下肢筋膜切开术治疗慢性运动性间隔综合征（CECS）的有效性。然而，并非所有患者的症状改善程度都相同。
特定的患者变量将导致下肢 CECS 筋膜切开术后的功能改善。
病例系列研究。
4 级。
对 2009 年至 2017 年期间由同一位外科医生进行的下肢筋膜切开术治疗 CECS 的患者进行了回顾性研究。收集了至少术后 12 个月的足部和踝关节能力测量-运动子量表（FAAM-Sports）、FAAM-Sports 单评估数字评估（SANE）和运动时疼痛的视觉模拟评分（VAS）的术前和术后测量值。通过计算术后与术前评分的差值，得出运动时 FAAM-Sports、FAAM-Sports SANE 和 VAS 变化的主要结果。进行了广义多元线性回归分析，以确定功能和疼痛改善的独立预测因素。
共有 61 名患者（58%的回复率）接受了 65 次手术，术后结果测量值在术后 57.9 个月（12-115 个月）的平均时间获得。患者的 FAAM-Sports 平均改善值为 40.4 ± 22.3 分（<0.001），FAAM-Sports SANE 改善值为 57.3 ± 31.6 分（<0.001），VAS 疼痛值降低 56.4 ± 31.8 分（<0.001）。多元线性回归分析显示，深层后间隔受累、年龄较小、抑郁史和男性是筋膜切开术后改善显著的独立预测因素。
筋膜切开术是治疗 CECS 的有效方法，本研究确定了某些患者变量可导致更大的功能改善。
男性患者、年轻患者、患有抑郁症的患者和深层后间隔受累的患者可能从筋膜切开术治疗 CECS 中获益更多。
