Chronic compartment syndrome: Diagnosis, management, and outcomes

A consecutive operative series of 100 patients with chronic compartment syndrome involving 233 compart ments is reported. Seven of every eight were athletes, and runners predominated. Exercise-induced symp toms of consistently recurring tightness, aching (in some, sharp pains) in anatomically defined compart ments were pathognomonic. Mean months of symp toms prior to operation was 22; median age was 26 years. Bilaterality occurred in 82. The distribution of compartments was: anterior, 39%; lateral, 12%; and posterior, 48%. Incidental compartment pressures were elevated (x = 23 mmHg). Fasciotomy using local anesthesia was performed on 70 outpatients. At a median of 4.5 months, over 90% were cured or signifi cantly improved in symptoms and/or function. Median time to walking unassisted was 2 days, and to resump tion of conditioned running 21 days. Fasciotomy can be a safe, effective, and economical treatment for chronic compartment syndrome.