■前臂慢性劳累性室综合征(CECS)在某些活跃人群中可能表现出相当大的功能损害,特别是摩托车赛车手。前臂CECS患者经常需要筋膜切开术以缓解症状并恢复运动(RTS)。
■评估前臂CECS筋膜切开术后运动员RTS的发生率,并比较筋膜切开术技术之间的RTS结果。
■系统评价;证据水平,4.
■遵守PRISMA(系统审查和荟萃分析的首选报告项目)指南,对PubMed的系统审查,Scopus,和Cochrane数据库从数据库开始到2022年12月进行,以确定前臂CECS接受筋膜切开术的所有已发表报告.对纳入的研究进行了人口统计信息分析,手术方法,康复参数,RTS费率,运动员恢复运动的手术时间,并发症,和复发。
■共38项研究(15个4级病例系列,23例报告),占500例患者(831例前臂)接受开放式筋膜切开术(112例),微创筋膜切开术(166例),内镜辅助筋膜切开术(222例)满足纳入标准。大多数患者(88.0%)是摩托车赛车手。任何水平的总RTS率(RTS-A)为94.2%(97.3%,92.2%,开放性筋膜切开术为98.5%,微创筋膜切开术,和内窥镜辅助筋膜切开术组,分别为;P=.010),受伤前或更高水平的总RTS为86.8%(95.9%,85.6%,开放性筋膜切开术为95.2%,微创筋膜切开术,和内窥镜辅助筋膜切开术组,分别;P=.132)。微创筋膜切开术和内镜辅助筋膜切开术组的RTS-A差异有统计学意义(P=.004)。总RTS时间为5.1±2.3周,患者满意度为85.1%,复发率为2.4%,筋膜切开术组之间没有显着差异(分别为P=.456,P=.886和P=.487)。
■接受前臂CECS筋膜切开术的患者RTS率高,快速RTS时间,高水平的满意度,复发率低。3种筋膜切开术的结果基本相似。
UNASSIGNED: Forearm chronic exertional compartment syndrome (CECS) can represent considerable functional impairment in certain active populations, particularly motorcycle racers. Patients with forearm CECS frequently require fasciotomy to relieve symptoms and return to sport (RTS).
UNASSIGNED: To evaluate the rate at which athletes RTS after fasciotomy for forearm CECS and to compare RTS outcomes between fasciotomy techniques.
UNASSIGNED: Systematic
review; Level of evidence, 4.
UNASSIGNED: Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic
review of the PubMed, Scopus, and Cochrane databases was performed from database inception to December 2022 to identify all published reports of forearm CECS managed with fasciotomy. Included studies were analyzed for demographic information, surgical approaches, rehabilitation parameters, RTS rates, time from surgery at which athletes resumed sport, complications, and recurrence.
UNASSIGNED: A total of 38 studies (15 level 4 case series, 23 case reports) accounting for 500 patients (831 forearms) who underwent open fasciotomy (112 patients), minimally invasive
fasciotomy (166 patients), and endoscopically assisted
fasciotomy (222 patients) satisfied inclusion criteria. Most patients (88.0%) were motorcycle racers. The overall RTS rate at any level (RTS-A) was 94.2% (97.3%, 92.2%, and 98.5% for the open fasciotomy, minimally invasive
fasciotomy, and endoscopically assisted
fasciotomy groups, respectively; P = .010), and the overall RTS at preinjury level or higher was 86.8% (95.9%, 85.6%, and 95.2% for the open fasciotomy, minimally invasive
fasciotomy, and endoscopically assisted
fasciotomy groups, respectively; P = .132). There was a significant difference in RTS-A between the minimally invasive fasciotomy and endoscopically assisted fasciotomy groups (P = .004). The overall RTS time was 5.1 ± 2.3 weeks, patient satisfaction was 85.1%, and the recurrence rate was 2.4%, and there were no significant differences between fasciotomy approach groups (P = .456, P = .886, and P = .487, respectively).
UNASSIGNED: Patients who underwent fasciotomy for forearm CECS had high rates of RTS, quick RTS time, high levels of satisfaction, and low rates of recurrence. Outcomes were largely similar between the 3 fasciotomy approaches.