The purpose of this literature review is to investigate whether non-operative treatments are as effective as fasciotomy at reducing symptoms in an active population with lower leg chronic exertional compartment syndrome (CECS). Chronic exertional compartment syndrome of the lower leg is a condition where with the onset of exercise the individual experiences burning, tightness, numbness, and/or weakness in a specific compartment of the lower leg. Fasciotomy is currently the gold standard treatment, but with success rates varying from 30% to 81% and symptom recurrence ranging from 8% to 44.7%, conservative treatments may provide a reasonable alternative to fasciotomy. The patient in this case is a 24-year-old female runner who had bilateral lower leg four compartment fasciotomies completed when she was 16 years old and presented with recurrence of her CECS symptoms. The patient did not want a revision fasciotomy and inquired about alternative treatment methods for helping to reduce her symptoms. Several databases were searched for current research regarding operative and non-operative treatment outcomes in active patients with CECS of the lower leg. Eight articles were selected and analyzed to investigate the answer to the proposed PICO question. There is little high quality evidence to support the effectiveness of either operative or non-operative treatment for the management of symptoms of CECS in the lower leg in an active population. Although current evidence does not lead to a conclusion about which treatment method is more effective, conservative treatments provide a safe, viable alternative for those who desire to avoid surgery.
Doctor of Physical Therapy (DPT)
Kathy Dieurf, DPT, NCS
Chronic exertional compartment syndrome, Fasciotomy, Non-operative treatment, Operative treatment
Bunting, Ashley M.. "Are non-operative treatments as effective as fasciotomy at reducing symptoms in an active population with lower leg chronic exertional compartment syndrome." (2018). https://digitalrepository.unm.edu/dpt/139