Surgical Decompression of Exertional Compartment Syndrome of the Forearm in Professional Motorcycling Racers: Comparative Long-term Results of Wide-Open Versus Mini-Open Fasciotomy.

Abstract

To compare the long-term results of 2 surgical techniques for forearm chronic exertional compartment syndrome (CECS) in professional motorcycling racers and to study a new diagnostic variable for CECS, TRest. Retrospective case series. 4. University Hospital. Thirty-four patients identified from a surgical database who had been operated on for upper-limb CECS. The purpose of the study was to report and compare the long-term results of 2 surgical techniques using fasciotomies [wide-open fasciotomy (WOF) versus mini-open fasciotomy (MOF)] for forearm CECS in professional motorcycling racers. Pain [visual analog scale (100-point scale)] and functional scores (Quick-DASH) at 3 months after surgery and at regular intervals during clinical visits. Surgical complications: Level of satisfaction with the outcome. Time to return to full activity after surgery. Thirty-four racers, 22 with bilateral involvement (n = 56), were diagnosed with CECS and were treated either with WOF (n = 24) or MOF (n = 32) depending on the surgeon's indication. Mini-open fasciotomy was usually selected in cases who need a faster recovery because of competition schedule. Visual analog scale and Quick-DASH improved 63 and 73 points, respectively (P < 0.001) with no significant difference between both surgical methods (P = 0.512). Both WOF and MOF were equally effective. Ninety-four percent of the patients were satisfied after 45.35 ± 12 months of follow-up, with no significant difference between surgical groups (P = 0.642). The time to return to full activity was 2.7 ± 1 week, also with no significant difference (P = 0.544). The time between when the stress testing was halted for pain and the return to baseline pressure (TRest) was superior to 15 minutes (defined as the mean minus 2 SDs) in 100% patients. Surgical open or mini-invasive fasciotomy is equally successful in motorcycling racers with forearm CECS. Although the sensitivity of TRest is quite high in our series, further studies are still needed to validate its diagnostic value. Surgical open or mini-invasive fasciotomy is equally successful in motorcycling racers with forearm CECS.