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 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