Medium- to Long-term Outcomes of Fasciotomy for Chronic Exertional Compartment Syndrome: A 6-Year Mean Follow-up Study

Abstract

Background: Operative treatment of chronic exertional compartment syndrome (CECS) with fasciotomy is effective for symptomatic resolution, but outcomes at medium- to long-term follow-up are unclear. Hypothesis: Patients will have favorable satisfaction at medium- to long-term follow-up and a high return to sport (RTS) rate after fasciotomy for treatment of CECS. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: Retrospective review of patients who underwent fasciotomy for treatment of CECS from 2010 to 2021. Outcomes were assessed using Tegner Activity Scale, symptom resolution, patient satisfaction, return to activities, and EQ-5D-5L survey. Results: Fifty patients (23 male and 27 female) were included. Mean age at time of surgery was 29.0 ± 11.6 years with mean follow-up 6.0 ± 2.3 years (range, 2.6-10.9). Tegner activity scores at final follow-up were improved compared with symptom onset (mean, 5.2 vs 3.3; P < 0.01). Increased preoperative symptom duration correlated with decreased RTS (β = -0.447; P = 0.01) and return to work (RTW) (β = -0.572; P = 0.01). Patients with a previous psychiatric diagnosis (n = 15) had lower rates of RTS (β = -0.358; P = 0.03) and RTW (β = -0.471, P = 0.02). Mean time to RTS was 5.5 ± 6.1 months. Mean visual analogue scale satisfaction rate was 74.4; 36 (72.0%) patients would be willing to have their fasciotomy again. Patients with fasciotomy of 1 to 2 compartments had higher Tegner score at final follow-up (P = 0.02) than those who had fasciotomy of >3 compartments; 19 (38.0%) patients reported experiencing paresthesia after their operation. No patients experienced major complications. Conclusion: Medium- to long-term outcomes of patients with CECS treated with fasciotomy demonstrated high satisfaction levels and high RTS rate. However, rate of minor complications including paresthesia, swelling, and cramping was high.