Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Am J Sports Med. 2024 Sep;52(11):2931-2938. doi: 10.1177/03635465231216368. Epub 2024 Feb 12.
Forearm chronic exertional compartment syndrome (CECS) can represent considerable functional impairment in certain active populations, particularly motorcycle racers. Patients with forearm CECS frequently require fasciotomy to relieve symptoms and return to sport (RTS).
To evaluate the rate at which athletes RTS after fasciotomy for forearm CECS and to compare RTS outcomes between fasciotomy techniques.
Systematic review; Level of evidence, 4.
Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review of the PubMed, Scopus, and Cochrane databases was performed from database inception to December 2022 to identify all published reports of forearm CECS managed with fasciotomy. Included studies were analyzed for demographic information, surgical approaches, rehabilitation parameters, RTS rates, time from surgery at which athletes resumed sport, complications, and recurrence.
A total of 38 studies (15 level 4 case series, 23 case reports) accounting for 500 patients (831 forearms) who underwent open fasciotomy (112 patients), minimally invasive fasciotomy (166 patients), and endoscopically assisted fasciotomy (222 patients) satisfied inclusion criteria. Most patients (88.0%) were motorcycle racers. The overall RTS rate at any level (RTS-A) was 94.2% (97.3%, 92.2%, and 98.5% for the open fasciotomy, minimally invasive fasciotomy, and endoscopically assisted fasciotomy groups, respectively; = .010), and the overall RTS at preinjury level or higher was 86.8% (95.9%, 85.6%, and 95.2% for the open fasciotomy, minimally invasive fasciotomy, and endoscopically assisted fasciotomy groups, respectively; = .132). There was a significant difference in RTS-A between the minimally invasive fasciotomy and endoscopically assisted fasciotomy groups ( = .004). The overall RTS time was 5.1 ± 2.3 weeks, patient satisfaction was 85.1%, and the recurrence rate was 2.4%, and there were no significant differences between fasciotomy approach groups ( = .456, = .886, and = .487, respectively).
Patients who underwent fasciotomy for forearm CECS had high rates of RTS, quick RTS time, high levels of satisfaction, and low rates of recurrence. Outcomes were largely similar between the 3 fasciotomy approaches.
前臂慢性运动性间隔综合征（CECS）在某些活跃人群中可能代表相当大的功能障碍，尤其是摩托车赛车手。患有前臂 CECS 的患者经常需要筋膜切开术来缓解症状并恢复运动（RTS）。
评估接受前臂 CECS 筋膜切开术的运动员的 RTS 率，并比较筋膜切开术技术的 RTS 结果。
系统评价；证据水平，4 级。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，对 PubMed、Scopus 和 Cochrane 数据库进行了系统综述，从数据库建立到 2022 年 12 月，以确定所有已发表的接受筋膜切开术治疗前臂 CECS 的报告。对纳入的研究进行了人口统计学信息、手术方法、康复参数、RTS 率、运动员从手术开始恢复运动的时间、并发症和复发情况的分析。
共有 38 项研究（15 项 4 级病例系列研究，23 项病例报告）纳入 500 名患者（831 只前臂），接受开放性筋膜切开术（112 名患者）、微创筋膜切开术（166 名患者）和内镜辅助筋膜切开术（222 名患者）。大多数患者（88.0%）是摩托车赛车手。任何水平的总体 RTS 率（RTS-A）为 94.2%（开放性筋膜切开术、微创筋膜切开术和内镜辅助筋膜切开术组分别为 97.3%、92.2%和 98.5%； =.010），术前或更高水平的总体 RTS 率为 86.8%（开放性筋膜切开术、微创筋膜切开术和内镜辅助筋膜切开术组分别为 95.9%、85.6%和 95.2%； =.132）。微创筋膜切开术和内镜辅助筋膜切开术组的 RTS-A 差异有统计学意义（ =.004）。总体 RTS 时间为 5.1±2.3 周，患者满意度为 85.1%，复发率为 2.4%，不同筋膜切开术方法组之间无显著差异（ =.456、 =.886 和 =.487）。
接受前臂 CECS 筋膜切开术的患者 RTS 率较高，RTS 时间较快，满意度较高，复发率较低。3 种筋膜切开术方法的结果基本相似。
