Eighteen patients (28 compartments) with
chronic exertional compartment syndrome and 14 normal asymptomatic volunteers (18 compartments) were studied. Evaluation included clinical assessment followed by quantitative determination of intracompartmental pressures as monitored by wick or slit
catheters before and after exercise. Intramuscular pressures measuring greater than or equal to 10 mmHg at rest and/or greater than or equal to 25 mmHg five minutes after exercise were defined as abnormally elevated. The patients with chronic
compartment syndrome described reproducible exertional anterolateral leg
pain, and 39% of these patients had a fascial
hernia. Such a defect was present in less than five percent of the normal volunteers. Nonsurgical treatment was selected by five patients and all five reported persistent inability to participate in athletics because of their exertional
pain. Of the remaining 13 patients, 12 were treated by decompressive
fasciotomy and 11 of the 12 (92%) had
pain relief and increased exercise tolerance. A single patient had had fascial closure instead of
fasciotomy, and this procedure produced an acute
compartment syndrome. Effective treatment of the chronic
compartment syndrome consists of reduction of exertional activities or
surgical decompression by
fasciotomy.