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Historic cohort: outcome of chronic exertional compartment syndrome-suspected patients
  1. Roy Maksymiak1,
  2. E Ritchie1,
  3. W Zimmermann2,3,
  4. N Maliko1,
  5. M van der Werve1,
  6. M Verschure4 and
  7. R Hoencamp5,6,7,8
  1. 1 Alrijne Hospital Leiderdorp, Leiderdorp, The Netherlands
  2. 2 Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  3. 3 Department of Military Sports Medicine, Royal Dutch Army, Utrecht, The Netherlands
  4. 4 Alrijne Ziekenhuis Leiden, Leiden, The Netherlands
  5. 5 Alrijne Zorggroep, Leiderdorp, The Netherlands
  6. 6 Defense Healthcare Organization, Ministry of Defence, Utrecht, The Netherlands
  7. 7 Trauma Research Unit Department of Surgery, University Medical Center Rotterdam, Erasmus MC, Rotterdam, Netherlands
  8. 8 Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
  1. Correspondence to E Ritchie, Alrijne Hospital Leiderdorp, Leiderdorp 2353 GA, The Netherlands; edritchie{at}


Introduction Exercise-related leg pain (ERLP) may be caused by chronic exertional compartment syndrome (CECS), occurring mainly in athletes and military recruits. In military populations, the effectiveness of surgical treatment in CECS is debated. The purpose of this study is to assess the outcome of surgical treatment for CECS in Alrijne Hospital (the Netherlands), a civilian hospital with supraregional referral function.

Methods A historic cohort study was performed on patients with ERLP who were suspected for CECS and were referred for intracompartmental pressure measurement (ICPM) from 2013 to 2017 (n=160). Patient demographics, ICPM and survey response were analysed.

Results The mean delay before visitation was 29.0±30.3 months. When comparing surgical-treated patients with CECS with conservative-treated patients with ERLP, surgical-treated patients were more satisfied, reported better recovery towards former level of performance (2.8±2.0 vs 3.9±1.7 and 2.5±1.6 vs 3.2±1.4 on a 7-point Likert scale, respectively) and better subjective injury status (79.3±22.6 vs 63.5±27.4 using the Single Assessment Numeric Evaluation score). Treatment satisfaction was 75.0% in surgical-treated CECS versus 51.4% in conservative-treated ERLP.

Conclusion Civilian patients report improved functional outcomes after fasciotomy for CECS. Future research should focus on non-invasive diagnostic options and methods to determine which treatment is the most appropriate for each individual patient.

  • CECS
  • fasciotomy
  • orthopaedic and trauma surgery
  • sports medicine

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • RM and ER are shared first authors.

  • Contributors ER and MvdW supplied the database. RM performed data analysis and writing of the manuscript. All authors were then involved in discussion and close supervision of the final paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.