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Exertional Compartment Syndrome Surgery

Exertional compartment syndrome, also called chronic compartment syndrome, is a condition that causes pain or cramps in the legs during exercise. This pain usually lessens on stopping the activity. It most often occurs in the front compartment of the lower leg. Athletes participating in sports such as running, biking, or swimming which require repetitive movements are at a greater risk of developing this condition.

The compartments in legs are groupings of muscles, blood vessels and nerves which are covered by a thick layer of tissue called fascia. The fascia holds the tissues within each compartment in place and is inelastic, which means it does not stretch or expand easily. In chronic exertional compartment syndrome, pressure builds-up within the muscles to an abnormally high level. Blood flow may then decrease causing inadequate supply of oxygen and nutrients to the nerve and muscle cells. Thus, nerve and muscle cells can get damaged.

The treatment options for chronic exertional compartment syndrome include both nonsurgical and surgical methods. Surgery may be needed if the conservative methods fail to resolve the pain or improve function. Fasciotomy is a surgical procedure that is performed to cut open the tight fascia to relieve pressure and allow more room for the muscles in the compartment. The fasciotomy procedure is performed in a hospital operating room under general anesthesia. Your surgeon makes an incision on the skin over the affected compartment.  Once there is access to the fascial layer, the fascia is cut away and removed to relieve the pressure within. Then leaving the fascia open, the overlying tissues and the skin incision are closed with sutures and a surgical dressing is placed.

Following fasciotomy, rehabilitation treatment which includes strengthening exercises to improve range of motion may be recommended. Patients who have undergone fasciotomy should avoid long periods of standing or walking.

Possible complications associated with fasciotomy may include shedding of the skin; infection; nerve damage, blood vessel, and muscle damage; and formation of scar tissue.