Systematic review of outcome parameters following treatment of chronic exertional compartment syndrome in the lower leg
Objective: Surgery is the gold standard in the management of chronic exertional compartment syndrome (CECS) of the lower extremity, although recent studies also reported success following gait retraining. Outcome parameters are diverse, and reporting is not standardized. The aim of this systematic review was to analyze the current evidence regarding treatment outcome of CECS in the lower leg. Material and Methods: A literature search and systematic analysis were performed according to the PRISMA criteria. Studies reporting on outcome following treatment of lower leg CECS were included. Results: A total of 68 reports fulfilled study criteria (n =; 3783; age range 12-70 year; 7:4 male-to-female ratio). Conservative interventions such as gait retraining (n =; 2) and botulinum injection (n =; 1) decreased ICP ((Formula presented.) =; 68 mm Hg to (Formula presented.) =; 32 mm Hg) and resulted in a 47% (±42%) rate of satisfaction and a 50% (±45%) rate of return to physical activity. Fasciotomy significantly decreased ICP ((Formula presented.) =; 76 mm Hg to (Formula presented.) =; 24 mm Hg) and was associated with an 85% (±13%) rate of satisfaction and an 80% (±17%) rate of return to activity. Return to activity was significantly more often achieved (P <.01) in surgically treated patients, except in one study favoring gait retraining in army personnel. Conclusion: Surgical treatment of CECS in the lower leg results in higher rates of satisfaction and return to activity, compared to conservative treatment. However, the number of studies is limited and the level of evidence is low. Randomized controlled trials with multiple treatment arms and standardized outcome parameters are needed.
|chronic exertional compartment syndrome, conservative treatment, fasciotomy, lower extremity, systematic review|
|Scandinavian Journal of Medicine & Science in Sports|
|Organisation||Department of Surgery|
Vogels, S. (Sanne), Ritchie, E.D. (Ewan D.), van Dongen, T.T.C.F. (Thijs T. C. F.), Scheltinga, M.R.M, Zimmermann, W.O. (Wes O.), & Hoencamp, R. (2020). Systematic review of outcome parameters following treatment of chronic exertional compartment syndrome in the lower leg. Scandinavian Journal of Medicine & Science in Sports. doi:10.1111/sms.13747