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Long-Term Outcome of Fasciotomy with Partial Fasciectomy for Chronic Exertional Compartment Syndrome of the Lower Leg

Drew Slimmon, Kim Bennell, PhD^,, Peter Brukner, MBBS, FACSP^,, Kay Crossley, BAppSci(physio)^, and Simon N. Bell, MBBS, FRACS

Centre for Sports Medicine Research and Education, School of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville
Olympic Park Sports Medicine Centre, Melbourne, Australia

Presented at the Fifth IOC World Congress, Sydney, Australia, November 1999.

Address correspondence and reprint requests to Kim Bennell, PhD, Centre for Sports Medicine Research and Education, School of Physiotherapy, University of Melbourne, Parkville, Vic 3010, Australia

Background: Fasciotomy with partial fasciectomy for compartment syndrome has had good short-term results, but no long-term studies have been performed.

Hypothesis: Combining a partial fasciectomy with fasciotomy for compartment syndrome relieves pain and eliminates symptoms in the long term.

Study Design: Retrospective cohort study.

Methods: A self-administered questionnaire was given to 62 patients at a mean follow-up of 51 months after surgery.

Results: Of the 50 patients who underwent a single operation, 60% (30) reported an excellent or good outcome. Average pain and pain-on-running were significantly reduced, although some subjects still reported considerable levels of pain. Fifty-eight percent (36 of 62) were exercising at a lower level than before injury and, of these, 36% (13) cited the return of their compartment syndrome or the development of a different lower leg compartment syndrome as the reason for a reduction in exercise levels. Some subjects indicated early initial improvement followed by subsequent deterioration.

Conclusion: This surgical technique reduces pain and allows the majority of patients to return to sports; however, patients should be counseled that they may not be able to return to their preinjury level of exercise or remain pain-free.

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