Aim

Defining universally accepted guidelines for the diagnosis and treatment of chronic exertional compartment syndrome (CECS) is hampered by the absence of high-quality scientific research. The aim of this Delphi study was to establish consensus on practical issues guiding diagnosis and treatment of CECS of the leg in civilian and military patient populations.

Methods

An international expert group was queried using the Delphi technique with a traditional three-round electronic consultation. Results of previous rounds were anonymously disclosed in the questionnaire of rounds 2 and 3, if relevant. Consensus was defined as > 70% positive or negative agreement for a question or statement.

Results

The panel consisted of 27 civilian and military healthcare providers. Consensus was reached on five essential key characteristics of lower leg CECS. The panel achieved partial agreement regarding standardization of the diagnostic protocol, including muscle tissue pressure measurements. Consensus was reached on conservative and surgical treatment regimens. However, the experts did not attain consensus on their approach of postoperative rehabilitation and preferred treatment approach of recurrent or residual disease. A summary of best clinical practice for the diagnosis and management of CECS was formulated by experts working in civilian and military healthcare facilities.

Conclusion

The Delphi panel reached consensus on key criteria for signs and symptoms of CECS and several aspects for conservative and surgical treatment. The panel did not agree on the role of ICP values in the diagnostic process, postoperative rehabilitation guidelines protocol, or the preferred treatment approach for recurrent or residual disease. These aspects serve as a first attempt to initiate simple guidelines for clinical practice.

中文翻译：

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下肢慢性劳力性筋膜室综合征诊治临床共识：德尔菲分析

目标

缺乏高质量的科学研究阻碍了为慢性劳力筋膜室综合征 (CECS) 的诊断和治疗定义普遍接受的指南。这项德尔菲研究的目的是就指导平民和军人患者群体腿部 CECS 诊断和治疗的实际问题达成共识。

方法

使用传统的三轮电子咨询，使用德尔菲技术询问国际专家组。如果相关，前几轮的结果会在第 2 轮和第 3 轮的问卷中匿名披露。共识被定义为 > 70% 对问题或陈述的正面或负面同意。

结果

该小组由 27 名民用和军用医疗保健提供者组成。就小腿 CECS 的五个基本关键特征达成了共识。该小组就诊断协议的标准化达成了部分协议，包括肌肉组织压力测量。就保守治疗和手术治疗方案达成了共识。然而，专家们对术后康复的方式以及复发或残留病灶的首选治疗方式并没有达成共识。民用和军用医疗机构的专家制定了 CECS 诊断和管理的最佳临床实践总结。

结论

Delphi 小组就 CECS 体征和症状的关键标准以及保守和手术治疗的几个方面达成了共识。专家组未就 ICP 值在诊断过程、术后康复指南方案或复发或残留疾病的首选治疗方法中的作用达成一致。这些方面是为临床实践启动简单指南的首次尝试。