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Clinical Outcomes of Forearm Fasciectomy for Treatment of Chronic Exertional Forearm Compartment Syndrome at Minimum One Year Follow-up
Benjamin R. Wiseley, BS; William D. Turnipseed, MD; Jonathan L. Tueting, MD
University of Wisconsin School of Medicine and Public Health, Madison, WI

Introduction: Chronic exertional compartment syndrome (CECS) of the forearm is an uncommon condition characterized by claudication of the forearm flexors and extensors brought on by repetitive use. CECS has been reported in patients who engage in softball, rowing, mountaineering, swimming, motocross racing, and weightlifting. Clinical symptoms manifest as pain, swelling, redness, tightness, numbness, tingling, and gradual forearm dysfunction. The only effective treatment for forearm CECS is surgical compartment release. The purpose of this retrospective case series is to evaluate the long-term outcomes of forearm fasciectomy as a treatment for forearm CECS.

Methods: After obtaining IRB approval, a retrospective case series was conducted on participants who had undergone forearm fasciectomy as a treatment for CECS. Participants were identified through clinical records and asked to complete a phone questionnaire and consent to a medical record review. The phone questionnaire used the QuickDASH tool to assess current forearm functionality and patient satisfaction. Data collected from the medical records included demographics, symptoms, diagnosis, outcomes, and complications.

Results: Thirteen patients (9 females, 4 males) who had surgical compartment release were identified over a 10 year period, 12 of which (9 females, 3 males) agreed to participate in the study. The mean age at the time of surgery was 22.4(+/-6.8) years and the average ICP measurement of the surgical arm was 40.9(+/-18.9) mmHg (normal ≤ 10 mmHg). Six patients had bilateral releases and 6 had unilateral releases, 18 fasciectomies total. The average follow-up time was 88.7(+/-31.2) months and the average QDASH score was 14.4(+/-13.4). Ten out of 12 patients stated they were satisfied with their outcome and the average estimate of current forearm function based on their previous level was 83.9%, with 4 out of 11 (36.4%) reporting a return to 100%. Four patients had a second release and the complication rate was 58%, with reports of hypertrophic scarring, hematomas, or adhesions. Four out of 12 reported lower limb symptoms of CECS.

Conclusion: Forearm fasciectomy appears to be an effective treatment for forearm CECS. 10 out of 12 patients were satisfied with their outcome and able to engage in their activities. This is further supported by the relatively low average QDASH score of 14.4 indicating very little forearm dysfunction after the surgery, based on the scoring system where 0 indicates no disability and 100 indicating more disability. This condition is more common in females and there is a high incidence of bilateral CECS in these patients.

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