Revista de Medicina Desportiva (English) March 2018 | Page 30

disease itself, does not seem to carry
permanent sequels, besides muscles
herniations, so the athletes perfor-
mance is not compromised. 1 The
post-operative recurrence rates in
forearm CECS, mainly in motorcy-
cling, around 3-12%. 6 Pre-operative
intra-compartmental pressure value
does not appear to be related to
clinical result. In fact, the only factor
proven to have prognostic relevance
is the time to diagnosis. 6
The authors declare no conflict of inte-
rests
Correspondence to:
Dr. Ana Luisa Neto-Hospital de Sant’Ana,
Parede
The champion Miguel Oliveira with elbow in flexion that causes a permanent forearm
tension
an alternative to fasciotomy. In fact,
studies has suggested similar symp-
tomatic results between both pro-
cedures, though fasciectomy seems
to be associated with a relevant
decrease in muscular strength. 16
Although open fasciotomy
remains the gold standard, mini-
mally invasive techniques, as endo-
scopic or multiple mini-approaches,
has recently achieved popularity
(figure 2). 5,8,24 The open surgery
main advantage is, undoubtedly, to
allow a through view of tissues, from
muscles to nerves and vessels, thus
decreasing the risk of complications
and disease recurrence. 1,14,15 On
the other hand, minimally invasive
surgery seems to provide a faster
rehabilitation and lower healing
area, allowing an earlier return to
activity. 1,2 Some authors have yet
described higher rates of complica-
tions with these techniques, particu-
larly limb hematomas, superficial infections, neurovascular lesions,
muscles herniation and incomplete
fascial release (Figure 3). 9,26 Despite
all of this, a study published in 2016
by Barrera-Ochoa, compared the
long term results of open and mini-
mally invasive surgery in motorcy-
clists, and concluded that both
techniques are equally effective in
the treatment of forearm CECS. He
also stated that minimally inva-
sive surgery has de highest minor
complication rate, although with no
statistical significance. 26
Figures 2a and 2b – Good clinical result
after minimally invasive fasciectomy Figure 3a and 3b – Extensive hematoma
member after a minimally invasive
fasciectomy
28 march 2018 www.revdesportiva.pt
Prognosis
Although not all of the patients
reach a complete relief of symp-
toms after surgery, the return rates
to activity are quit high, with good
clinical short term results. 1 The
References
1. Liu, B., Barrazueta, G., Ruchelsman, D.E.. Chro-
nic exertional compartment syndrome in athletes,
J Han