Copyright
©The Author(s) 2021.
World J Orthop. May 18, 2021; 12(5): 320-328
Published online May 18, 2021. doi: 10.5312/wjo.v12.i5.320
Published online May 18, 2021. doi: 10.5312/wjo.v12.i5.320
Table 1 Background and clinical information of patients with chronic exertional compartment syndrome of the forearm who underwent endoscopic fasciotomy
| Ref. | Sample size | Gender | Age (mean and range) | Sport/risk factor | Diagnostic investigations | Preoperative VAS score (mean and range) | Preoperative DASH score (mean and range) | Preoperative quick DASH score (mean and range) |
| Abe and Fujii[10], 2017 | 1 (unilateral) | 1 F | 15 | Tennis; This case involved the mobile wad only | Compartment pressure measurements (at rest, under stress and after stress) US and MRI | -- | -- | -- |
| Hijjawi and Nagle[14], 2010 | 1 (unilateral) | 1 M | 33 | Truck driver | Compartment pressure measurements (at rest and after stress) | -- | -- | -- |
| Jans et al[11], 2015 | 154 (all bilateral) | 151 M; 3 F | 32.7; 16-42 | Motocross racers | MRI after flexor loading (repetitive grip until exhaustion for 15 minutes) | 1.1 ± 0.3 at rest and 7.4 ± 1.5 after stress (used scale of 1 to 10) | -- | -- |
| Miller et al[17], 2017 | 2 (1 bilateral) | 2 M | 24.5; 23-26 | Motocross racers | Compartment pressure measurements (at rest and after stress) | 9.5; 9-10 (used scale of 0 to 10) | -- | -- |
| Pegoli et al[15], 2016 | 3 (1 bilateral) | 3 M | 25.3 | Motorcycle drivers | Compartment pressure measurements (at rest, under stress and after stress) | 4.5; 3-6 (used scale of 0 to 10) | 21.71%; 18.42-25.00% | -- |
| Ruyer et al[16], 2020 | 21 (15 bilateral) | 21 M | 28; 14-42 | Motorcycle road racing (n = 20), off-road motorcycle racing or enduro (n = 11), quad racing (n = 4) and mountain biking and water skiing (n = 1) | Compartment pressure measurements (pre- and post-stress) | -- | -- | 23 ± 10%; 7-45% |
| Seiler et al[18], 2011 | 1 (bilateral) | 1 F | 19 | Swimmer | Compartment pressure measurements (after stress) | -- | -- | -- |
Table 2 Surgical technique used for endoscopic fasciotomy of the forearm for chronic exertional compartment syndrome
| Ref. | Sample size | Surgical technique | ||
| Special tools | Incisions | Other surgical notes | ||
| Abe and Fujii[10], 2017 | 1 (unilateral) | 2.3 mm endoscope with 30° angle | 1 cm single incision, 2 cm proximal to the point of tenderness | Release of brachioradialis fascia (case involved mobile wad only) |
| Hijjawi and Nagle[14], 2010 | 1 (unilateral) | 4.5 mm 30° endoscope and probe blade from Chow dual-port endoscopic carpal tunnel set | 2 incision: 2 cm transverseincision was made at the junction of the middle and distal thirds of the forearm in line with the flexor-pronator muscles; another 2 cm incision made 4 cm distal to the elbow crease | -- |
| Jans et al[11], 2015 | 154 (all bilateral) | The single-use Vasoview 7 Endoscopic Vessel Harvesting System (Maquet–Getinge Group, Rastatt, Germany) | Single 3 cm volar incision between flexor carpi radialis tendon and palmaris longus tendon made 4 cm proximal to the wrist | Decompression of the superficial flexor compartment done up to 3 cm distal to cubital fold |
| Miller et al[17], 2017 | 2 (1 bilateral) | EndoRelease (Integra LifeSciences Corporation,Plainsboro, New Jersey) system | Single incision over the subcutaneous border of the ulna midway between olecranon and ulnar styloid | -- |
| Pegoli et al[15], 2016 | 3 (1 bilateral) | STORZ endoscopy set | Single 2 cm volar incision: Line drawn between medial epicondyle to wrist flexion crease ulnar to palmaris longus tendon, then divided into 4 parts. Incision is made between first and second quarters proximally | Fasciotomy between flexor carpi radialis/palmaris longus tendons laterally and flexor carpi ulnaris medially |
| Ruyer et al[16], 2020 | 21 (15 bilateral) | SmartRelease® (previously Agee®) endoscopic system (Micro- Aire Surgical Instruments, VA, United States) | Incision based on the involved compartments: Line drawn between medial epicondyle to middle of wrist flexion crease anteriorly, and between lateral epicondyle and Lister’s tubercle posteriorly. 2 or 3 small incisions are made along the lines to fit the 6 cm long endoscopic knife | -- |
| Seiler et al[18], 2011 | 1 (bilateral) | 0° endoscope and electrocautery forceps | 3 incisions: dorsal incision just proximal to extensor retinaculum along a line between lateral epicondyle and Lister’s tubercle; volar incision made along a line between palmaris longus tendon and biceps tendon, proximal incision made 1 cm distal to the midline of the antecubital fossa, and distal incision at the wrist crease just ulnar to palmaris longus tendon | -- |
Table 3 Outcomes and complications of endoscopic fasciotomy of the forearm for chronic exertional compartment syndrome
| Ref. | Sample size | Follow-up duration | Postoperative VAS score (mean and range) | Postoperative DASH score (mean and range) | Postoperative quick DASH score (mean and range) | Return to sports | Other outcomes | Recurrence | Complications | |
| Abe and Fujii[10], 2017 | 1 (unilateral) | 7 mo | -- | -- | -- | Returned 2 mo postoperatively | Pain free at 4 mo postoperatively | None | None | |
| Hijjawi and Nagle[14], 2010 | 1 (unilateral) | 6 mo | -- | -- | -- | -- | Pain free at final follow-up | None | None | |
| Jans et al[11], 2015 | 154 (all bilateral) | 6 wk | 1.0 ± 0.2 at rest and 1.7 ± 0.9 after stress (used scale of 1 to 10) | -- | -- | All returned 6 wk postoperatively | -- | 1 recurrence 8 mo postoperatively | 5 hematomas requiring drainage | |
| Miller et al[17], 2017 | 2 (1 bilateral) | 1 mo (only specified for 1 case) | 0.0 | -- | -- | Both returned 1 wk postoperatively | Improved grip strength and wrist ROM | None | 1 case had small seroma resolved with compressive wrapping at 2 wk postoperatively | |
| Pegoli et al[15], 2016 | 3 (1 bilateral) | 45.80 mo (34-55) | 0.75; 0-2 (used scale of 0 to 10) | 5.39%; 2.15-10.05% | -- | All returned 3 wk postoperatively | -- | None | None | |
| Ruyer et al[16], 2020 | 21 (15 bilateral) | 4.9 ± 2.7 yr (range: 1.0-10.2)3 patients lost follow-up | -- | -- | 1 ± 2%; 0-9% | Returned at 4.3 ± 1.8 wk (range: 3-8 wk) postoperatively | 14 were very satisfied with the procedure, 3 were satisfied, and 1 was moderately satisfied. | 2 recurrence due to fibrous scar tissues requiring revision fasciotomy; revision was open for one of them | 2 superficial vascular injury, 1 superficial sensory nerve injury, 2 hematomas (1 requiring drainage), 3 transient hypoesthesia (recovered at 3 mo postoperatively). 2 lateral epicondylalgia | |
| Seiler et al[18], 2011 | 1 (bilateral) | 9 mo | -- | 5.0% | -- | Returned 3 wk postoperatively; full level at 6 wk postoperatively | Pain free at final follow-up | None | None | |
- Citation: Marwan Y, Addar A, Algarni N, Algarni N, Burman M, Martineau PA. Endoscopic fasciotomy for chronic exertional compartment syndrome of the forearm: Systematic review of outcomes and complications. World J Orthop 2021; 12(5): 320-328
- URL: https://www.wjgnet.com/2218-5836/full/v12/i5/320.htm
- DOI: https://dx.doi.org/10.5312/wjo.v12.i5.320