Poster 393: Recurrence Rates of Exertional Compartment Syndrome: Endoscopic Fasciotomies vs Open Fasciotomies

Abstract

Objectives: Chronic Exertional Compartment Syndrome (CECS) is a debilitating condition characterized by increased pressure within myofascial compartments often during exercise. Fasciotomy of the affected compartment is the primary treatment for refractory cases, with two main techniques commonly employed: endoscopic-assisted fasciotomy and open fasciotomy. This study compared the rates of recurrence and rates of infection in endoscopic-assisted fasciotomy and open fasciotomy. Methods: This is a retrospective cohort study of all patients diagnosed with CECS at two level 1 trauma centers between January 2006-December 2019. Data related to patient demographics, follow-up, infection rate, and recurrence rate were collected from electronic medical records. Results: There were 169 patients included in the study, with 66 undergoing endoscopically-assisted fasciotomy and 103 undergoing open fasciotomy. The average patient age was 32±11 years and 29±12 years for the endoscopic and open groups, respectively. There were 37 females (56%) in endoscopic group and 62 females (60%) in the open group. The average BMI was 29±7 and 28±6 for the endoscopic and open groups, respectively. There were 10 former smokers in each group and 1 active smoker in the open group. Average follow-up was 9±10 months and 10±15 months for the endoscopic and open groups, respectively. There were no significant differences in age, sex, BMI, smoking habit, or length of follow-up between the two groups. There were 8 infections (12%) in the endoscopic group compared to 14 infections (14%) in the open group (p=0.81). There were 8 revisions (12%) in the endoscopic group compared to 4 revisions (4%) in the open group (p=0.04). Conclusions: Endoscopically-assisted fasciotomy patients demonstrated a higher recurrence rate of CECS compared to those who underwent open fasciotomy. This may be explained my increased technical demands of endoscopic procedures and incomplete release of fascial compartments. Further research and long-term follow-up studies are warranted to elucidate the underlying mechanisms and optimize treatment strategies to reduce recurrence rates and enhance patient outcomes.