The results of fasciotomy in the management of chronic exertional compartment syndrome

Twenty-five patients with well-documented clinical history and elevated tissue pressures were subjected to surgical fasciotomy of the respective compartment (anterior, 13; anterior and posterior, 4; deep posterior, 8). The indications for surgery were resting pressures in excess of 15 mmHg and elevated postexercise pressure measurements with delayed normalization. Twenty-two patients were satisfied with the procedure and were able to return to athletics. There were three failures, all of whom had decompression of the deep posterior compartment. This study has demonstrated that fasciotomy of the anterior compartment, when done with the correct indications, gives excellent relief of chronic anterior leg pain. It is recommended that fasciotomy of the deep posterior compartment include a formal release of the tibialis posterior at the time of decompression.