In conclusion, a 2-compartment fasciotomy or a 4-compartment fasciotomy for lower leg chronic exertional compartment syndrome appears to be equally successful. Rate of satisfaction (2-compartment 74%-89% 4-compartment 75%-100%) and residual symptoms (2-compartment 0%-36% 4-compartment 0%-50%) indicated no group differences. Mean Marx activity score of 1 study found a small significant standardized mean difference (0.196 ) favoring 4-compartment fasciotomy. Both 2-compartment and 4-compartment fasciotomy were associated with a 50% to 100% “return to activity” rate (in studies reporting group results separately: 2-compartment 90%-100% 4-compartment 50%-100%) and a 41% to 100% “return to previous activity” rate (in studies reporting group results separately: 2-compartment 82-100% 4-compartment 50%-100%) without significant differences.
Quality assessment revealed a high risk of bias in all studies. Seven studies reporting on altogether 194 athletes and military personnel (mean age 24 y) were included. Fibula: The smaller lateral bone of the lower leg. The proximal portion of the tibia is tibial plateau which acts as a cusp for the knee, the distal portion tapers into the medial malleoli and the concave surface which articulates with the talus at the ankle joint. Risk of bias and levels of evidence were determined. Tibia: The medial, larger bone of the lower leg.
Compartments of lower leg series#
Controlled clinical trials (randomized/nonrandomized), cohort studies and case series reporting on outcome following either 2-compartment or 4-compartment fasciotomy for lower leg chronic exertional compartment syndrome were searched until in PubMed, EMBASE, and Cochrane. The purpose of this systematic review was to compare patient-reported outcomes of a 2-compartment fasciotomy with a 4-compartment fasciotomy. However, it is unknown whether number of simultaneously opened compartments affects outcome. Fasciotomy is the surgical gold standard. Patients with lower leg chronic exertional compartment syndrome are impaired due to exercise-related pain.
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