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The evaluation of the treatment of 10 cases of chronic compartmental syndrome of the upper arm
  1. X Gasol,
  2. M A García,
  3. A Turmo,
  4. X Valle
  1. Centre d'Alt Rendiment de Sant Cugat del Vallès, Barcelona, Sports Medicine School, University of Barcelona, Barcelona, Spain

Abstract

Chronic compartment syndrome (CCS) is a pathological situation in which there is an increase in the interstitial muscular pressure which produces a conflict of microcirculation and enervation. The main characteristic is pain and stiffness during activity with intense neurovascular symptoms.

The initial presentation is clinical with diagnosis confirmed by an intracompartmental pressure measurement (ICP) to confirm the diagnosis. Other non-invasive diagnostic techniques like magnetic resonance imaging and near infrared spectroscopy produce less clear results.

Conventional treatment reduces the symptoms but its application presents difficulties for sportspeople. Fasciotomy is still the treatment of choice followed by postsurgical rehabilitation, although the possibility of relapse cannot be discounted.

Materials and methods 10 sportspersons have been studied with CCS, diagnosed by ICP, and looked at in the medical department of CAR Sant Cugat during the period 2003–2009. Personal characteristics were: age: 31.5 years +12.07; weight: 72.4 kg + 6.55: height 171.4 cm+4.95; IMC 24.67+2.42; one woman and nine men. The Whitesides technique was used for administering the PIC and the Pedowitz criteria for confirming the diagnosis. The treatment was evaluated using a test based on Slimon et al (2002). The patients evaluated the results as bad, medium, good or excellent. The pain was evaluated on a subjective scale of 1–10 together with the presence or absence of weakness, muscular contractions or paresthesia.

Results 10 subjects diagnosed with CCS (8 flexors and 8 extensors). The latent diagnostic period was from 18,6 months±19,8.

Over the total 16, 10 were treated with fasciotomy and 6 with conventional treatment.

Total recovery: using fasciotomy 9 versus conservative 0. Using fasciotomy, the total recuperation period took more than a year in eight cases. Compartments with an unsatisfactory therapeutic result: fasciotomy 1, conservative 6. Two cases diagnosed as CCS without fulfilling the Pedowitz criteria due to an extended recovery time. These two cases were given conservative treatment but were not complete a good recovery.

Conclusion The latency diagnostic period are long

Fasciotomy comes out as the better treatment but with recovery times longer than a year in all cases except one.

The recovery time of basal pressure during the test seems a variable worth taking into account independently of the Pedowitz criteria, so for that reason we think it deserve an analysis in greater depth.

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