Compartment Pressure Curves Predict Surgical Outcome in Chronic Deep Posterior Compartment Syndrome
Background: Results of surgery for chronic exertional compartment syndrome (CECS) of the lower leg deep posterior compartment are inferior compared with other types of CECS. Factors predicting success after surgery are unknown. Purpose: To study the prognostic value of preoperative compartmental pre...
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| Veröffentlicht in: | The American journal of sports medicine 2012-08, Vol.40 (8), p.1899-1905 |
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| creator | Winkes, Michiel B. Hoogeveen, Adwin R. Houterman, Saskia Giesberts, Anouk Wijn, Pieter F. Scheltinga, Marc R. |
| description | Background:
Results of surgery for chronic exertional compartment syndrome (CECS) of the lower leg deep posterior compartment are inferior compared with other types of CECS. Factors predicting success after surgery are unknown.
Purpose:
To study the prognostic value of preoperative compartmental pressure curves in patients receiving surgery for deep posterior compartment CECS.
Study Design:
Case series; Level of evidence, 4.
Methods:
Intracompartmental pressures (ICPs) of patients with deep posterior lower leg CECS were obtained at 4 time points (ie, before, immediately after, and 1 and 5 minutes after a standard exercise challenge test). Area under the 4-point pressure curve was calculated. Patients received a questionnaire investigating residual symptoms after surgery.
Results:
A complete data set was available for 52 patients (men, n = 23; age, 33 ± 14 years). They rated their 3-month postoperative clinical outcome as excellent (14%), good (38%), fair (35%), or poor (13%). Outcome at 3 months was related to the area under the preoperative 4-point pressure curve (excellent, 127 ± 28; good, 113 ± 25; fair, 100 ± 22; and poor, 88 ± 15; P = .005; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.08). At the long-term follow-up (39 ± 24 months), all 5 cardinal symptoms (pain, tight feeling, cramps, weakness, and diminished sensibility) were greatly attenuated (P < .001) in the successfully operated group. Long-term success was 48%. Delay in diagnosis was related to poor outcome (P = .04). Correlations between pressures/area under the 4-point pressure curve and long-term outcome were not significant, however.
Conclusion:
Preoperative measured intracompartmental pressures obtained in rest and after a standard exercise test may predict success of surgery for deep posterior compartment CECS of the lower limb. Further standardizing of preoperative pressure protocols may confirm that compartmental pressure analysis has diagnostic as well as predictive properties. |
| doi_str_mv | 10.1177/0363546512449324 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1032735601</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546512449324</sage_id><sourcerecordid>1032735601</sourcerecordid><originalsourceid>FETCH-LOGICAL-c395t-2eb48876a09ebd54594266ff6f33cd5c638975f5ff9d18cfd086062c8a43c27e3</originalsourceid><addsrcrecordid>eNp10d1r2zAQAHAxWta02_ueiqAM-uJW35Ifh7tuhUIC6Z6NIp9Sl9jKJLvQ_34yybYQ6JM47nen4w6hL5TcUKr1LeGKS6EkZUKUnIkPaEalZAXnSp6g2ZQupvwZOk_phRBCtTIf0RljmpWS8BlyVei2Ng4d9ANeREhpjICrMb5CmuKmdQNejnHdOrvB83FwoQPc9rh6jqFvHb4D2OJFSAPENkR82G751jcx80_o1NtNgs_79wL9uv_-VP0sHuc_Hqpvj4XjpRwKBithjFaWlLBqpJClYEp5rzznrpFOcVNq6aX3ZUON8w0xiijmjBXcMQ38Al3v-m5j-D1CGuquTQ42G9tDGFNNCWeaS0VopldH9CWMsc_TTYozIowWWZGdcjGkFMHX29h2Nr5lVE8HqI8PkEsu943HVQfNv4K_G8_g6x7YlFfqo-1dm_47xQwpjcmu2Llk13A43Tsf_wGO6Jm3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1033204874</pqid></control><display><type>article</type><title>Compartment Pressure Curves Predict Surgical Outcome in Chronic Deep Posterior Compartment Syndrome</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Winkes, Michiel B. ; Hoogeveen, Adwin R. ; Houterman, Saskia ; Giesberts, Anouk ; Wijn, Pieter F. ; Scheltinga, Marc R.</creator><creatorcontrib>Winkes, Michiel B. ; Hoogeveen, Adwin R. ; Houterman, Saskia ; Giesberts, Anouk ; Wijn, Pieter F. ; Scheltinga, Marc R.</creatorcontrib><description>Background:
Results of surgery for chronic exertional compartment syndrome (CECS) of the lower leg deep posterior compartment are inferior compared with other types of CECS. Factors predicting success after surgery are unknown.
Purpose:
To study the prognostic value of preoperative compartmental pressure curves in patients receiving surgery for deep posterior compartment CECS.
Study Design:
Case series; Level of evidence, 4.
Methods:
Intracompartmental pressures (ICPs) of patients with deep posterior lower leg CECS were obtained at 4 time points (ie, before, immediately after, and 1 and 5 minutes after a standard exercise challenge test). Area under the 4-point pressure curve was calculated. Patients received a questionnaire investigating residual symptoms after surgery.
Results:
A complete data set was available for 52 patients (men, n = 23; age, 33 ± 14 years). They rated their 3-month postoperative clinical outcome as excellent (14%), good (38%), fair (35%), or poor (13%). Outcome at 3 months was related to the area under the preoperative 4-point pressure curve (excellent, 127 ± 28; good, 113 ± 25; fair, 100 ± 22; and poor, 88 ± 15; P = .005; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.08). At the long-term follow-up (39 ± 24 months), all 5 cardinal symptoms (pain, tight feeling, cramps, weakness, and diminished sensibility) were greatly attenuated (P < .001) in the successfully operated group. Long-term success was 48%. Delay in diagnosis was related to poor outcome (P = .04). Correlations between pressures/area under the 4-point pressure curve and long-term outcome were not significant, however.
Conclusion:
Preoperative measured intracompartmental pressures obtained in rest and after a standard exercise test may predict success of surgery for deep posterior compartment CECS of the lower limb. Further standardizing of preoperative pressure protocols may confirm that compartmental pressure analysis has diagnostic as well as predictive properties.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546512449324</identifier><identifier>PMID: 22729503</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood pressure ; Cardiology. Vascular system ; Chronic Disease ; Compartment Syndromes - diagnosis ; Compartment Syndromes - physiopathology ; Compartment Syndromes - surgery ; Diseases of the osteoarticular system ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; Humans ; Legs ; Lower Extremity ; Male ; Manometry ; Medical disorders ; Medical prognosis ; Medical sciences ; Middle Aged ; Pressure ; Prognosis ; Sports medicine ; Surgery ; Surgical outcomes ; Treatment Outcome ; Young Adult</subject><ispartof>The American journal of sports medicine, 2012-08, Vol.40 (8), p.1899-1905</ispartof><rights>2012 The Author(s)</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Sage Publications Ltd. Aug 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c395t-2eb48876a09ebd54594266ff6f33cd5c638975f5ff9d18cfd086062c8a43c27e3</citedby><cites>FETCH-LOGICAL-c395t-2eb48876a09ebd54594266ff6f33cd5c638975f5ff9d18cfd086062c8a43c27e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546512449324$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546512449324$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,782,786,21828,27933,27934,43630,43631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26280988$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22729503$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Winkes, Michiel B.</creatorcontrib><creatorcontrib>Hoogeveen, Adwin R.</creatorcontrib><creatorcontrib>Houterman, Saskia</creatorcontrib><creatorcontrib>Giesberts, Anouk</creatorcontrib><creatorcontrib>Wijn, Pieter F.</creatorcontrib><creatorcontrib>Scheltinga, Marc R.</creatorcontrib><title>Compartment Pressure Curves Predict Surgical Outcome in Chronic Deep Posterior Compartment Syndrome</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
Results of surgery for chronic exertional compartment syndrome (CECS) of the lower leg deep posterior compartment are inferior compared with other types of CECS. Factors predicting success after surgery are unknown.
Purpose:
To study the prognostic value of preoperative compartmental pressure curves in patients receiving surgery for deep posterior compartment CECS.
Study Design:
Case series; Level of evidence, 4.
Methods:
Intracompartmental pressures (ICPs) of patients with deep posterior lower leg CECS were obtained at 4 time points (ie, before, immediately after, and 1 and 5 minutes after a standard exercise challenge test). Area under the 4-point pressure curve was calculated. Patients received a questionnaire investigating residual symptoms after surgery.
Results:
A complete data set was available for 52 patients (men, n = 23; age, 33 ± 14 years). They rated their 3-month postoperative clinical outcome as excellent (14%), good (38%), fair (35%), or poor (13%). Outcome at 3 months was related to the area under the preoperative 4-point pressure curve (excellent, 127 ± 28; good, 113 ± 25; fair, 100 ± 22; and poor, 88 ± 15; P = .005; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.08). At the long-term follow-up (39 ± 24 months), all 5 cardinal symptoms (pain, tight feeling, cramps, weakness, and diminished sensibility) were greatly attenuated (P < .001) in the successfully operated group. Long-term success was 48%. Delay in diagnosis was related to poor outcome (P = .04). Correlations between pressures/area under the 4-point pressure curve and long-term outcome were not significant, however.
Conclusion:
Preoperative measured intracompartmental pressures obtained in rest and after a standard exercise test may predict success of surgery for deep posterior compartment CECS of the lower limb. Further standardizing of preoperative pressure protocols may confirm that compartmental pressure analysis has diagnostic as well as predictive properties.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood pressure</subject><subject>Cardiology. Vascular system</subject><subject>Chronic Disease</subject><subject>Compartment Syndromes - diagnosis</subject><subject>Compartment Syndromes - physiopathology</subject><subject>Compartment Syndromes - surgery</subject><subject>Diseases of the osteoarticular system</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Female</subject><subject>Humans</subject><subject>Legs</subject><subject>Lower Extremity</subject><subject>Male</subject><subject>Manometry</subject><subject>Medical disorders</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pressure</subject><subject>Prognosis</subject><subject>Sports medicine</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10d1r2zAQAHAxWta02_ueiqAM-uJW35Ifh7tuhUIC6Z6NIp9Sl9jKJLvQ_34yybYQ6JM47nen4w6hL5TcUKr1LeGKS6EkZUKUnIkPaEalZAXnSp6g2ZQupvwZOk_phRBCtTIf0RljmpWS8BlyVei2Ng4d9ANeREhpjICrMb5CmuKmdQNejnHdOrvB83FwoQPc9rh6jqFvHb4D2OJFSAPENkR82G751jcx80_o1NtNgs_79wL9uv_-VP0sHuc_Hqpvj4XjpRwKBithjFaWlLBqpJClYEp5rzznrpFOcVNq6aX3ZUON8w0xiijmjBXcMQ38Al3v-m5j-D1CGuquTQ42G9tDGFNNCWeaS0VopldH9CWMsc_TTYozIowWWZGdcjGkFMHX29h2Nr5lVE8HqI8PkEsu943HVQfNv4K_G8_g6x7YlFfqo-1dm_47xQwpjcmu2Llk13A43Tsf_wGO6Jm3</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Winkes, Michiel B.</creator><creator>Hoogeveen, Adwin R.</creator><creator>Houterman, Saskia</creator><creator>Giesberts, Anouk</creator><creator>Wijn, Pieter F.</creator><creator>Scheltinga, Marc R.</creator><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Compartment Pressure Curves Predict Surgical Outcome in Chronic Deep Posterior Compartment Syndrome</title><author>Winkes, Michiel B. ; Hoogeveen, Adwin R. ; Houterman, Saskia ; Giesberts, Anouk ; Wijn, Pieter F. ; Scheltinga, Marc R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c395t-2eb48876a09ebd54594266ff6f33cd5c638975f5ff9d18cfd086062c8a43c27e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood pressure</topic><topic>Cardiology. Vascular system</topic><topic>Chronic Disease</topic><topic>Compartment Syndromes - diagnosis</topic><topic>Compartment Syndromes - physiopathology</topic><topic>Compartment Syndromes - surgery</topic><topic>Diseases of the osteoarticular system</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Female</topic><topic>Humans</topic><topic>Legs</topic><topic>Lower Extremity</topic><topic>Male</topic><topic>Manometry</topic><topic>Medical disorders</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pressure</topic><topic>Prognosis</topic><topic>Sports medicine</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Winkes, Michiel B.</creatorcontrib><creatorcontrib>Hoogeveen, Adwin R.</creatorcontrib><creatorcontrib>Houterman, Saskia</creatorcontrib><creatorcontrib>Giesberts, Anouk</creatorcontrib><creatorcontrib>Wijn, Pieter F.</creatorcontrib><creatorcontrib>Scheltinga, Marc R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Winkes, Michiel B.</au><au>Hoogeveen, Adwin R.</au><au>Houterman, Saskia</au><au>Giesberts, Anouk</au><au>Wijn, Pieter F.</au><au>Scheltinga, Marc R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Compartment Pressure Curves Predict Surgical Outcome in Chronic Deep Posterior Compartment Syndrome</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>40</volume><issue>8</issue><spage>1899</spage><epage>1905</epage><pages>1899-1905</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background:
Results of surgery for chronic exertional compartment syndrome (CECS) of the lower leg deep posterior compartment are inferior compared with other types of CECS. Factors predicting success after surgery are unknown.
Purpose:
To study the prognostic value of preoperative compartmental pressure curves in patients receiving surgery for deep posterior compartment CECS.
Study Design:
Case series; Level of evidence, 4.
Methods:
Intracompartmental pressures (ICPs) of patients with deep posterior lower leg CECS were obtained at 4 time points (ie, before, immediately after, and 1 and 5 minutes after a standard exercise challenge test). Area under the 4-point pressure curve was calculated. Patients received a questionnaire investigating residual symptoms after surgery.
Results:
A complete data set was available for 52 patients (men, n = 23; age, 33 ± 14 years). They rated their 3-month postoperative clinical outcome as excellent (14%), good (38%), fair (35%), or poor (13%). Outcome at 3 months was related to the area under the preoperative 4-point pressure curve (excellent, 127 ± 28; good, 113 ± 25; fair, 100 ± 22; and poor, 88 ± 15; P = .005; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.08). At the long-term follow-up (39 ± 24 months), all 5 cardinal symptoms (pain, tight feeling, cramps, weakness, and diminished sensibility) were greatly attenuated (P < .001) in the successfully operated group. Long-term success was 48%. Delay in diagnosis was related to poor outcome (P = .04). Correlations between pressures/area under the 4-point pressure curve and long-term outcome were not significant, however.
Conclusion:
Preoperative measured intracompartmental pressures obtained in rest and after a standard exercise test may predict success of surgery for deep posterior compartment CECS of the lower limb. Further standardizing of preoperative pressure protocols may confirm that compartmental pressure analysis has diagnostic as well as predictive properties.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>22729503</pmid><doi>10.1177/0363546512449324</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Blood and lymphatic vessels Blood pressure Cardiology. Vascular system Chronic Disease Compartment Syndromes - diagnosis Compartment Syndromes - physiopathology Compartment Syndromes - surgery Diseases of the osteoarticular system Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female Humans Legs Lower Extremity Male Manometry Medical disorders Medical prognosis Medical sciences Middle Aged Pressure Prognosis Sports medicine Surgery Surgical outcomes Treatment Outcome Young Adult |
| title | Compartment Pressure Curves Predict Surgical Outcome in Chronic Deep Posterior Compartment Syndrome |
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