Abstract: Chronic exertional compartment syndrome (CECS) is an underdiagnosed condition that causes lower and upper extremity pain in certain at-risk populations. Lower-extremity CECS is most often observed in running athletes and marching military members. Upper-extremity CECS is most commonly seen in rowers and professional motorcyclists. Although early outcome research on CECS has been based mostly on adult male patients, there has been an increase in the number of studies in pediatric and adolescent patient populations, particularly in females. Evaluation of CECS must include a thorough history and physical exam to rule out other causes of exertional leg pain, but differential diagnosis must remain high on the list. Needle manometry can be used to confirm diagnosis of CECS by measuring intracompartmental pressure. Operative treatment of CECS with fasciotomy has been shown to be effective in resolution of CECS, and new surgical techniques are being developed. In the pediatric population, endoscopy-assisted compartment release has provided high success rates with low complication rates. Nonoperative management of CECS is more commonly described in the literature, and consists of cessation of activities, altering foot-strike pattern, physical therapy, taping, and injections of botulinum toxin A. Nonetheless, larger samples and a more diverse population are needed to better understand the outcomes of nonoperative management. There have been fewer studies on upper-extremity CECS, given its rarity. Success has been found in the treatment of upper-extremity CECS with open fasciotomy, but more studies are needed to understand the efficacy of minimally invasive techniques in the upper extremity. Further research also needs to be done to understand why a large portion (approximately 20%) of the patient population does not experience full resolution of symptoms after fasciotomy.

Keywords: chronic exertional compartment syndrome, CECS lower extremity, CECS upper extremity, pediatric CECS




中文翻译：

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慢性劳累性室综合征：当前的治疗策略

摘要：慢性劳累性室间隔综合征（CECS）是一种诊断不足的疾病，在某些高危人群中引起下肢和上肢疼痛。下肢CECS最常见于跑步运动员和军人行进中。上肢CECS最常见于赛艇运动员和专业摩托车手中。尽管关于CECS的早期结果研究主要基于成年男性患者，但儿童和青少年患者群体，特别是女性的研究数量有所增加。CECS的评估必须包括全面的病史和体格检查，以排除运动性腿痛的其他原因，但鉴别诊断必须始终排在首位。针头测压可以通过测量房内压来确认CECS的诊断。已经证明，采用筋膜切开术对CECS进行手术治疗可有效解决CECS，并且正在开发新的外科手术技术。在儿科人群中，内窥镜辅助腔室释放提供了较高的成功率和较低的并发症发生率。CECS的非手术治疗在文献中更为常见，包括停止活动，改变脚部敲击模式，物理疗法，包扎和注射肉毒杆菌毒素A。但是，需要更大的样本量和更多的人群以更好地治疗了解非手术治疗的结果。鉴于其稀有性，关于上肢CECS的研究很少。在开放性筋膜切开术治疗上肢CECS方面已获得成功，但是需要更多的研究来了解微创技术在上肢的疗效。还需要做进一步的研究，以了解为什么大部分患者（约20％）在筋膜切开术后不能完全缓解症状。

关键词：慢性运动性室综合征，CECS下肢，CECS上肢，小儿CECS