This 2003 JAAOS review covers the diagnosis and surgical management of chronic exertional compartment syndrome (CECS) — a cause of exertional leg pain in athletes driven by pathologically elevated intracompartmental pressure. It addresses anatomy, pathophysiology, pressure measurement criteria, fasciotomy techniques for the leg, thigh, and forearm, and published outcomes across compartment locations.
When an athlete presents with reproducible, compartment-localized leg pain that starts predictably with exercise and resolves with rest, measure postexercise compartment pressures using the Pedowitz thresholds to confirm CECS. If nonsurgical modification fails or is refused, fasciotomy of the confirmed compartment is the treatment of choice — but temper expectations for deep posterior releases and document preoperative pressures to support the decision.
This 2003 JAAOS review covers the diagnosis and surgical management of chronic exertional compartment syndrome (CECS) — a cause of exertional leg pain in athletes driven by pathologically elevated intracompartmental pressure. It addresses anatomy, pathophysiology, pressure measurement criteria, fasciotomy techniques for the leg, thigh, and forearm, and published outcomes across compartment locations.
When an athlete presents with reproducible, compartment-localized leg pain that starts predictably with exercise and resolves with rest, measure postexercise compartment pressures using the Pedowitz thresholds to confirm CECS. If nonsurgical modification fails or is refused, fasciotomy of the confirmed compartment is the treatment of choice — but temper expectations for deep posterior releases and document preoperative pressures to support the decision.