Surgical Management of Chronic Exertional Compartment Syndrome of the Lower Extremity: Outcome Analysis and Return to Sport.

ABSTRACT

OBJECTIVE: To evaluate patient-reported outcomes and return to sport after open fasciotomy for lower extremity chronic exertional compartment syndrome (CECS). DESIGN: Retrospective case series. SETTING: Foot and ankle specialty service at a large multisite academic medical center. PATIENTS 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. INTERVENTIONS: Retrospective email/telephone follow-up. MAIN OUTCOME MEASURES: Return to sports questionnaire, the Foot and Ankle Ability Measure-Sports subscale, and visual analog scale for pain. RESULTS: 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. CONCLUSIONS: This study demonstrates that lower extremity fasciotomy for CECS results in improvement of patient-reported outcomes and a high rate of return to sport.