226
· DOS Abstracts
Diagnosis and treatment of chronic exertional
compartment syndrome - a proposition for an
algorithm based on case series of patients
treated at Sports Medicine Division, Department of Orthopaedic
Surgery, Viborg Regional Hospital, Denmark
Peter Birk, Steffen Skov Jensen, Bente Overgaard Hansen, Janni Stroem
Ortopæd kirurgisk afd. T, Viborg Regionshospital; Ortopæd kirurgisk afd. T, fy-
sioterapien, Viborg Regionshospital; Ortopæd kirurgisk afd. T, klinisk sygepleje,
Viborg Regionshospital
Background:
Chronic exertional compartment syndrome (CECS) is a well rec-
ognized but often under diagnosed cause of chronic exertional lower extremity
pain, most often encountered in young physically active individuals.
Purpose / Aim of Study:
The aim of this preliminary study is to present an al-
gorithm for diagnosis and treatment of CECS. We hypothesize that specific ac-
tivity induced strain (SAIS) can be used to diagnose the specific affected com-
partments, and in this way be able to safely and effectively treat this disorder
using endoscopic assisted selective fasciotomy (EASF).
Materials and Methods:
Retrospective follow-up study of 13 consecutive
selected patients seen in the period from Nov 2011 to May 2014 (6 women
and 7 men, mean age 26 years, range 15-46 years). We used an algorithm of
MRI scan or bone scintegraphy to rule out other pathology. Subsequently the
patient was examined by a physiotherapist and exposed to SAIS. The objective
findings in conjunction with a thorough medical history formed the basis for the
diagnosis.
Findings / Results:
11 patients were offered surgical treatment consisting of
EASF of the affected compartment (10 bilateral and 1 unilateral, 8 affected
in specific compartments and 3 affected in all compartments. Only 1 patient
required additional EASF of other compartments than primarily diagnosed. At
three months follow up 82% of the patients had regained their physical capabili-
ties as prior to the condition.
Conclusions:
Diagnosing CECS using an algorihm consisting of physiotherapist
examination including SAIS allows the surgeon to diagnose the specific affected
compartments. In our study we can conclude that this practice represents a
reliable diagnostic identifier, and that EASF is a safe and effective surgical treat-
ment. Further studies are needed to confirm the benefits.
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