Minimally Invasive Treatment of Chronic Exertional Compartment Syndrome: A Case Series

Authors

DOI:

https://doi.org/10.15417/issn.1852-7434.2026.91.3.2357

Keywords:

Chronic exertional compartment syndrome, fasciotomy, minimally invasive surgery, leg pain

Abstract

Introduction: Chronic exertional compartment syndrome causes exertion-induced limb pain. It predominantly affects young athletes and the diagnosis is confirmed by measuring intracompartmental pressure. Fasciotomy is the treatment of choice when symptoms do not respond to conservative management. Minimally invasive decompression has gained increasing attention because of its lower morbidity and faster patient recovery.

Objective: To describe the surgical technique and its clinical, functional, and patient-reported outcomes.

Materials and Methods: A retrospective descriptive study was conducted on three men with chronic exertional compartment syndrome who underwent surgery between 2021 and 2025. The following variables were analyzed: demographic characteristics, pain assessed using the Visual Analog Scale (VAS), function assessed using PROMIS®, quality of life assessed using the EuroQol-5D, sports activity level assessed using the Tegner Activity Scale, complications, and patient satisfaction.

Results: The median age was 27 years. Pain decreased from 10 to 2. The PROMIS® T-score increased from 49.0 to 55.0, and the EuroQol-5D score increased from 0.85 to 1.0. Two patients exceeded their preinjury sports activity level, and one returned to the same level. One minor complication was recorded.

Conclusions: Minimally invasive fasciotomy achieved satisfactory preliminary clinical and functional outcomes; however, larger comparative studies are needed to validate these findings.

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Author Biographies

  • Virginia María Cafruni, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Julieta Brué, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Ana Cecilia Parise, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Leonardo Á. Conti, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Daniel S. Villena, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Guillermo Cardone, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos
    Aires, Argentina

  • María Gala Santini Araujo, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

References

Tarabishi MM, Almigdad A, Almonaie S, Farr S, Mansfield C. Chronic exertional compartment syndrome in

athletes: an overview of the current literature. Cureus 2023;15(10):e47797. https://doi.org/10.7759/cureus.47797 DOI: https://doi.org/10.7759/cureus.47797

Nwakibu U, Schwarzman G, Zimmermann WO, Hutchinson MR. Chronic exertional compartment syndrome

of the leg management is changing: where are we and where are we going? Curr Sports Med Rep 2020;19(10):438-44. https://doi.org/10.1249/JSR.0000000000000762 DOI: https://doi.org/10.1249/JSR.0000000000000762

Velasco TO, Leggit JC. Chronic exertional compartment syndrome: A clinical update. Curr Sports Med Rep 2020;19(9):347-52. https://doi.org/10.1249/JSR.0000000000000747 DOI: https://doi.org/10.1249/JSR.0000000000000747

Pedowitz RA, Hargens AR, Mubarak SJ, Gershuni DH. Modified criteria for the objective diagnosis of chronic compartment syndrome of the leg. Am J Sports Med 1990;18(1):35-40. https://doi.org/10.1177/036354659001800106 DOI: https://doi.org/10.1177/036354659001800106

Campano D, Robaina JA, Kusnezov N, Dunn JC, Waterman BR. Surgical management for chronic exertional compartment syndrome of the leg: A systematic review of the literature. Arthroscopy 2016;32(7):1478-86. https://doi.org/10.1016/j.arthro.2016.01.069 DOI: https://doi.org/10.1016/j.arthro.2016.01.069

Barrera-Ochoa S, Haddad S, Correa-Vázquez E, Font Segura J, Gil E, Lluch A, et al. Surgical decompression of exertional compartment syndrome of the forearm in professional motorcycling racers: Comparative long-term results of wide-open versus mini-open fasciotomy. Clin J Sport Med 2016;26(2):108-14. DOI: https://doi.org/10.1097/JSM.0000000000000216

https://doi.org/10.1097/JSM.0000000000000216g/

Oliver WM, Rhatigan D, Mackenzie SP, White TO, Duckworth AD, Molyneux SG. Outcome following mini-open lower limb fasciotomy for chronic exertional compartment syndrome. Eur J Orthop Surg Traumatol 2022;32(1):27-

https://doi.org/10.1007/s00590-021-02919-z DOI: https://doi.org/10.1007/s00590-021-02919-z

Broderick JM, Synnott KA, Mulhall KJ. Minimally invasive fasciotomy using a lighted retractor in the treatment of chronic exertional compartment syndrome. J Orthop Surg (Hong Kong) 2020;28(1):2309499019892800. https://doi.org/10.1177/2309499019892800 DOI: https://doi.org/10.1177/2309499019892800

Croutzet P, Chassat R, Masmejean EH. Mini-invasive surgery for chronic exertional compartment syndrome of the forearm: a new technique. Tech Hand Up Extrem Surg 2009;13(3):137-40. https://doi.org/10.1097/BTH.0b013e3181aa9193 DOI: https://doi.org/10.1097/BTH.0b013e3181aa9193

Drexler M, Rutenberg TF, Rozen N, Warschawski Y, Rath E, Chechik O, et al. Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications. Arch Orthop Trauma Surg 2017;137(1):73-9. https://doi.org/10.1007/s00402-016-2569-7 DOI: https://doi.org/10.1007/s00402-016-2569-7

Callender NW, Lu E, Martin KD. Chronic exertional compartment syndrome of the lower extremity: diagnosis and surgical treatment. JBJS Essent Surg Tech 2022;12(4):e21.00059. https://doi.org/10.2106/JBJS.ST.21.00059 DOI: https://doi.org/10.2106/JBJS.ST.21.00059

Edwards PH, Wright ML, Hartman JF. A practical approach for the differential diagnosis of chronic leg pain in the athlete. Am J Sports Med 2005;33(8):1241-9. https://doi.org/10.1177/0363546505278305 DOI: https://doi.org/10.1177/0363546505278305

Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res1985;(198):43-9. PMID: 4028566 DOI: https://doi.org/10.1097/00003086-198509000-00007

Hunt KJ, Lakey E. Patient-reported outcomes in foot and ankle surgery. Orthop Clin North Am 2018;49(2):277-89. https://doi.org/10.1016/j.ocl.2017.11.014 DOI: https://doi.org/10.1016/j.ocl.2017.11.014

Matas A. Diseño del formato de escalas tipo Likert: un estado de la cuestión. Revista electrónica de investigación educativa 2018;20(1):38-47. https://doi.org/10.24320/redie.2018.20.1.1347 DOI: https://doi.org/10.24320/redie.2018.20.1.1347

Plessen CY, Fischer F, Hartmann C, Liegl G, Schalet B, Kaat AJ, et al. Differential item functioning between English, German, and Spanish PROMIS® physical function ceiling items. Qual Life Res 2025;34(5):1377-91. https://doi.org/10.1007/s11136-024-03866-y. DOI: https://doi.org/10.1007/s11136-024-03866-y

Paz SH, Spritzer KL, Morales LS, Hays RD. Evaluation of the Patient-Reported Outcomes Information System (PROMIS(®)) Spanish-language physical functioning items. Qual Life Res 2013;22(7):1819-30. https://doi.org/10.1007/s11136-012-0292-6 DOI: https://doi.org/10.1007/s11136-012-0292-6

Herdman M, Badia X, Berra S. El EuroQol-5D: una alternativa sencilla para la medición de la calidad de vida relacionada con la salud en atención primaria. [EuroQol-5D: a simple alternative for measuring health-related quality of life in primary care]. Aten Primaria 2001;28(6):425-30. https://doi.org/10.1016/s0212-6567(01)70406-4 DOI: https://doi.org/10.1016/S0212-6567(01)70406-4

Thein R, Tilbor I, Rom E, Herman A, Haviv B, Burstein G, et al. Return to sports after chronic anterior exertional compartment syndrome of the leg: Conservative treatment versus surgery. J Orthop Surg (Hong Kong) 2019;27(2):2309499019835651. https://doi.org/10.1177/2309499019835651 DOI: https://doi.org/10.1177/2309499019835651

Grechenig P, Valsamis EM, Müller T, Gänsslen A, Hohenberger G. Minimally invasive lower leg fasciotomy for chronic exertional compartment syndrome-How safe is it? A cadaveric study. Orthop J Sports Med 2020;8(10):2325967120956924. https://doi.org/10.1177/2325967120956924 DOI: https://doi.org/10.1177/2325967120956924

Maffulli N, Loppini M, Spiezia F, D’Addona A, Maffulli GD. Single minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg. J Orthop Surg Res 2016;11(1):61. https://doi.org/10.1186/s13018-016-0395-9 DOI: https://doi.org/10.1186/s13018-016-0395-9

Baumfeld D, Silva M, Simões AP, Baumfeld T. Mini open fasciotomy for chronic exertional compartment syndrome: A prospective case series. Foot Ankle Spec 2023;19386400231216010. https://doi.org/10.1177/19386400231216006 DOI: https://doi.org/10.1177/19386400231216006

Lohrer H, Nauck T, Lohrer L. Endoscopic-assisted release of lower leg chronic exertional compartment syndromes: Results of a systematic literature review. Sports Med Arthrosc 2016;24(1):19-23. https://doi.org/10.1097/JSA.0000000000000106 DOI: https://doi.org/10.1097/JSA.0000000000000106

Ding A, Machin M, Onida S, Davies AH. A systematic review of fasciotomy in chronic exertional compartment syndrome. J Vasc Surg 2020;72(5):1802-12. https://doi.org/10.1016/j.jvs.2020.05.030 DOI: https://doi.org/10.1016/j.jvs.2020.05.030

Paik RS, Pepple DA, Hutchinson MR. Chronic exertional compartment syndrome. BMJ 2013;346:f33.

https://doi.org/10.1136/bmj.f33 DOI: https://doi.org/10.1136/bmj.f33

Wilder RP, Magrum E. Exertional compartment syndrome. Clin Sports Med 2010;29(3):429-35.

https://doi.org/10.1016/j.csm.2010.03.008 DOI: https://doi.org/10.1016/j.csm.2010.03.008

Dunn JC, Waterman BR. Chronic exertional compartment syndrome of the leg in the military. Clin Sports Med

;33(4):693-705. https://doi.org/10.1016/j.csm.2014.06.010 DOI: https://doi.org/10.1016/j.csm.2014.06.010

van den Brand JGH, Nelson T, Verleisdonk EJMM, van der Werken C. The diagnostic value of intracompartmental pressure measurement, magnetic resonance imaging, and near-infrared spectroscopy

in chronic exertional compartment syndrome: a prospective study in 50 patients. Am J Sports Med 2005;33(5):699-704. https://doi.org/10.1177/0363546504270565 DOI: https://doi.org/10.1177/0363546504270565

Duarte ML, De Queiroz Pereira Silva A, Da Silva Xavier F, Masson De Almeida Prado JL. Chronic exertional compartment syndrome. Medicina (B Aires) 2023;83(3):497. PMID: 37379556

Nico MAC, Carneiro BC, Zorzenoni FO, Ormond Filho AG, Guimarães JB. The role of magnetic resonance in the diagnosis of chronic exertional compartment syndrome. Rev Bras Ortop (Sao Paulo) 2020;55(6):673-80.

https://doi.org/10.1055/s-0040-1702961 DOI: https://doi.org/10.1055/s-0040-1702961

Published

2026-06-30

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Clinical Research

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How to Cite

Minimally Invasive Treatment of Chronic Exertional Compartment Syndrome: A Case Series. (2026). Revista de la Asociación Argentina de Ortopedia Y Traumatología, 91(3), 215-224. https://doi.org/10.15417/issn.1852-7434.2026.91.3.2357

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