Ultrasound-guided fasciotomy in forearm chronic exertional compartment syndrome: Preliminary results in 12 cases

IF 0.9 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2024-06-01 DOI:10.1016/j.hansur.2024.101719

Jean-Baptiste Facon , Nicolas Mainard , Pascal Louis , Philippe-Alexandre Faure , Jean-Michel Cognet

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引用次数: 0

Abstract

Introduction

Forearm chronic exertional compartment syndrome is a rare condition in athletes and musicians who perform repeated prolonged forced gripping movements. It mainly affects young men, and presents with cramp-like pain, beginning on the anteromedial side of the forearm and progressively extending to the entire circumference, and may be associated with muscle weakness and neurologic symptoms. The objective of this study was to report preliminary results of ultrasound-guided fasciotomy in the treatment of forearm chronic exertional compartment syndrome.

Material and methods

A single-center retrospective observational study was conducted. Forearm chronic exertional compartment syndrome was diagnosed on clinical presentation and pathological intramuscular pressure measurement, defined as >30 mmHg at 1 min after effort. The series comprised 7 men, with bilateral involvement. Mean age was 30 years. All patients were motorcyclists. The mean preoperative intramuscular pressure at 1 min after effort was 60.75 mmHg (range: 30−81 mmHg). The main study endpoint was change in pain on visual analogic scale. Secondary endpoints comprised patient satisfaction, change in competitive sports level, and time to return to sport. Complications were noted.

Results

Six patients (12 forearms) were evaluated. Mean follow-up was 22.5 months (range: 3–48 months). Mean pain rating was 7.3/10 (range: 6–9) preoperatively, and 0/10 postoperatively. All patients were satisfied with the procedure. Mean time to return to sports was 25.5 days (range: 21–30 days). No patients decreased their competitive sports level after the procedure. One patient presented a postoperative hematoma, not requiring surgery.

Conclusion

Ultrasound-guided fasciotomy in the treatment of Forearm chronic exertional compartment syndrome is an innovative technique with promising preliminary results.

Level of Evidence

IV; retrospective cohort.

查看原文本刊更多论文

超声引导下筋膜切开术治疗前臂慢性劳损性筋膜室综合征：12 个病例的初步结果。

简介前臂慢性用力隔室综合征是一种罕见病，多发于反复长时间用力抓握动作的运动员和音乐家。它主要影响年轻男性，表现为抽筋样疼痛，从前臂前内侧开始，逐渐扩展到整个周身，并可能伴有肌无力和神经症状。本研究旨在报告超声引导下筋膜切开术治疗前臂慢性劳损性筋膜室综合征的初步结果：材料和方法：这是一项单中心回顾性观察研究。前臂慢性劳损性筋膜室综合征的诊断依据是临床表现和病理肌内压测量值，即劳损后 1 分钟肌内压>30 mmHg。该系列共有 7 名男性患者，均为双侧受累。平均年龄为 30 岁。所有患者都是摩托车手。术前用力 1 分钟后的平均肌压为 60.75 mmHg（范围：30-81 mmHg）。研究的主要终点是视觉类比量表显示的疼痛变化。次要终点包括患者满意度、竞技运动水平的变化以及恢复运动的时间。研究还记录了并发症：共对 6 名患者（12 个前臂）进行了评估。平均随访时间为 22.5 个月（3-48 个月）。术前平均疼痛评分为 7.3/10（范围：6-9），术后为 0/10。所有患者都对手术感到满意。恢复运动的平均时间为 25.5 天（范围：21-30 天）。没有患者在术后降低运动竞技水平。一名患者术后出现血肿，但无需手术：结论：超声引导下筋膜切开术治疗前臂慢性劳损性筋膜室综合征是一项创新技术，初步结果令人鼓舞：证据级别：IV；回顾性队列

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.