OBJECTIVES: To review the literature and identify current management strategies used in the treatment of chronic compartment syndrome and discuss their effectiveness. DESIGN: Systematic review of papers published between 1980 to 2002 which focused primarily on the conservative or surgical management of chronic compartment syndrome of the lower leg. The articles were mainly expert opinions or retrospective surgical cases. Consequently a modified assessment criteria had to be devised to critique the quality of the papers. DATA SOURCE: Medline, PEDro, Cochrane, ScienceDirect, Sports Rehab and hand searching of relevant articles cited in the review papers. RESULTS: Of the 83 articles generated, 14 articles were found to concentrate on the management of compartment syndrome of the lower leg. The other articles dealt mainly with the anatomy, pathophysiology or diagnostic techniques and were therefore excluded from the review. The studies varied in the thoroughness of the diagnostic criteria, the pressure measurement techniques and the surgical method. Some papers described the conservative management used prior to surgery, however no statistical comparisons were made between outcomes of conservative therapy versus surgical intervention. The outcome measures used across the studies were primarily subjective in nature and follow-up times were not standardised. CONCLUSION: The quality of research in this area has large scope for improvement. Conservative management received little attention in the literature although most studies alluded to the fact that it had been unsuccessful in their patients. There is a strong need to explore this in greater depth. Although randomisation into surgical and conservative groups poses ethical dilemmas, researchers can overcome this by implementing a standardised conservative program in all patients prior to surgery. The quality of evidence to support surgical intervention needs to be more vigorous. At present, there is only anecdotal evidence to support surgical management over conservative, as treatment of choice in chronic compartment syndrome of the lower leg.

There are no links to full text for this record.