Background:Forearm chronic exertional compartment syndrome (CECS) can represent considerable functional impairment in certain active populations, particularly motorcycle racers. Patients with forearm CECS frequently require fasciotomy to relieve symptoms and return to sport (RTS).Purpose:To evaluate the rate at which athletes RTS after fasciotomy for forearm CECS and to compare RTS outcomes between fasciotomy techniques.Study Design:Systematic review; Level of evidence, 4.Methods:Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review of the PubMed, Scopus, and Cochrane databases was performed from database inception to December 2022 to identify all published reports of forearm CECS managed with fasciotomy. Included studies were analyzed for demographic information, surgical approaches, rehabilitation parameters, RTS rates, time from surgery at which athletes resumed sport, complications, and recurrence.Results:A total of 38 studies (15 level 4 case series, 23 case reports) accounting for 500 patients (831 forearms) who underwent open fasciotomy (112 patients), minimally invasive fasciotomy (166 patients), and endoscopically assisted fasciotomy (222 patients) satisfied inclusion criteria. Most patients (88.0%) were motorcycle racers. The overall RTS rate at any level (RTS-A) was 94.2% (97.3%, 92.2%, and 98.5% for the open fasciotomy, minimally invasive fasciotomy, and endoscopically assisted fasciotomy groups, respectively; P = .010), and the overall RTS at preinjury level or higher was 86.8% (95.9%, 85.6%, and 95.2% for the open fasciotomy, minimally invasive fasciotomy, and endoscopically assisted fasciotomy groups, respectively; P = .132). There was a significant difference in RTS-A between the minimally invasive fasciotomy and endoscopically assisted fasciotomy groups ( P = .004). The overall RTS time was 5.1 ± 2.3 weeks, patient satisfaction was 85.1%, and the recurrence rate was 2.4%, and there were no significant differences between fasciotomy approach groups ( P = .456, P = .886, and P = .487, respectively).Conclusion:Patients who underwent fasciotomy for forearm CECS had high rates of RTS, quick RTS time, high levels of satisfaction, and low rates of recurrence. Outcomes were largely similar between the 3 fasciotomy approaches.

中文翻译：

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前臂慢性劳力筋膜室综合征筋膜切开术后恢复运动：系统评价

背景：前臂慢性肌筋膜室综合征 (CECS) 可能会导致某些活跃人群（尤其是摩托车赛车手）出现严重的功能障碍。前臂CECS患者经常需要筋膜切开术来缓解症状并恢复运动（RTS）。目的：评估前臂CECS筋膜切开术后运动员RTS的比率，并比较筋膜切开术技术之间的RTS结果。研究设计：系统评价；证据水平，4.方法：遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南，从数据库建立到 2022 年 12 月，对 PubMed、Scopus 和 Cochrane 数据库进行了系统评价，以识别所有已发表的报告前臂 CECS 采用筋膜切开术进行治疗。对纳入的研究进行了人口统计信息、手术方法、康复参数、RTS 率、运动员恢复运动的手术时间、并发症和复发等方面的分析。 结果：总共 38 项研究（15 项 4 级病例系列，23 项病例报告）统计接受开放筋膜切开术（112 例患者）、微创筋膜切开术（166 例患者）和内镜辅助筋膜切开术（222 例患者）的 500 名患者（831 前臂）满足纳入标准。大多数患者（88.0%）是摩托车赛车手。任何级别的总体 RTS 率 (RTS-A) 均为 94.2%（开放筋膜切开术、微创筋膜切开术和内镜辅助筋膜切开术组分别为 97.3%、92.2% 和 98.5%；P = .010），并且损伤前水平或更高水平的总体 RTS 为 86.8%（开放筋膜切开术组、微创筋膜切开术组和内镜辅助筋膜切开术组分别为 95.9%、85.6% 和 95.2%；P = .132）。微创筋膜切开术组和内镜辅助筋膜切开术组之间的 RTS-A 存在显着差异 (P = .004)。总 RTS 时间为 5.1 ± 2.3 周，患者满意度为 85.1%，复发率为 2.4%，筋膜切开入路组之间没有显着差异（ P = .456、P = .886 和 P = .487）结论：前臂CECS接受筋膜切开术的患者RTS率高、RTS时间短、满意度高、复发率低。三种筋膜切开术的结果基本相似。