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Ultrasound-Guided Fasciotomy for Chronic Exertional Compartment Syndrome

A Case Report

Finnoff, Jonathan T. DO*; Johnson, Wade DO

doi: 10.1097/JSM.0000000000000777
Case Report: PDF Only

Abstract: Chronic exertional compartment syndrome (CECS) is characterized by an excessive increase in intracompartmental muscle pressures after exercise. Athletes with CECS report pain, pressure, and occasionally neurologic symptoms in the affected compartment during exercise that abates with rest. Although many treatment options have been proposed, athletes often require a fasciotomy to return to unrestricted sports participation. Surgical success rates vary; complications are not uncommon; and after surgery, it usually takes athletes 6 or more weeks to return to unrestricted impact activities. This case report describes a new ultrasound-guided fasciotomy technique for the treatment of anterior leg compartment CECS. The procedure required a 3 mm incision, was performed in the office under local anesthesia, and allowed the athlete to resume running within 1 week of the procedure. Although the preliminary results of this study are promising, further translational research is required before the widespread adoption of this procedure is recommended.

*Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; and

Department of Physical Medicine and Rehabilitation, Mayo Clinic Sports Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota

Corresponding Author: Jonathan T. Finnoff, DO, Mayo Clinic Sports Medicine Center, 600 Hennepin Ave, #310, Minneapolis, MN 55403 (

J. T. Finnoff is on the Medical Advisory Boards for COVR Medical, Sanofi, and Aim Specialty Health and receives royalties from Demos Publishing and Up to Date. The authors otherwise report no conflicts of interest.

Received February 22, 2019

Accepted June 19, 2019

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