Fasciotomy as treatment of Chronic exertional compartment syndrome of the deep posterior compartment - a prospective study

Chronic exertional compartment syndrome is charecterised by pain and loss of
function. The symptoms occur due to tightness of the conective tissue
surrounding the muscles or due to hyperthropy of the muscles within the
conective tissue. Chronic exertional compartment syndrome of the anterior
compartment leads to typical complaints and has a good correlation between the
complaints and the affected muscles in the afflicted compartment. The
exertional compartment syndrome of the deep posterior compartment has a less
typical complaintspattern. It is therefor less easily recognisable. The
location between the fibula, the tibia and the other compartments gives rise to
the theory that a fasciotomy gives less pressure relieve for the afflicted
compartment.

This study aimes to investigate wheter or not a fasciotomy of the deep
posterior compartment of the lower leg leads to a lowering of the
intracompartimental pressure, an objective parameter. . This study will also
investigate wheter or not a fasciotomy leads to a subjective improvements of
complaints. The primary goal of this investigation is to determine if a
fasciotomy of the deep posterior compartment leads to a decrease in pressure
in that same compartment. The secundary goal of this investigation is to
determine whether or not a fasciotomy of the deep posterior compartment of the
lower leg leads an improvenmtent of pain and quality of life.

This study is a prospective study. There will be no randomisation. Patients
with elevated pressures in the deep posterior compartment are allegeble and
will be approached to participate in the study. Questionnairies will be taken
before and after surgery. Six weeks after surgery intracompartimental pressure
readings will be repeated.

Filling in of the questionnaires should take no more then 30 minutes. The
intracompartmental pressure measurement is repeated six weeks after surgery.
This measurement takes approx. 45 minutes.

Intracompartmental pressure measurement is performed as follows: the skin is
desinfected and locally anesthetized. A slit-catheter is placed in the deep
posterior comparment and fixated. Pressure measurements are then performed in
sitting and upright position pre-exercise, during exercise and in sitting and
upright position after the patient has exercised.