Beekhuis-Heerema, M.T. (2015) Het succes van een fasciotomie bij het inspanningsgebonden compartimentsyndroom en de relatie met een dynamische drukmeting. thesis, Medicine.
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Abstract
Introduction: The pressure of the intramuscular compartment is abnormally increased in the exercise induced compartment syndrome (EICS). The Pedowitz-criteria are used as the gold standard for intra-compartmental pressure measurement. Standard treatment for EICS is fasciotomy. The result of the fasciotomy for the anterior compartment is 65% up to 100% and for the deep posterior compartment 48% up to 75%. Primary goal: Explore the success rate of the fasciotomy of the lower leg at the EICS of the anterior and the deep posterior compartment. Secondary goal: Compare the predictive value for successful fasciotomy of the Pedowitz-criteria with dynamic pressure measurement of the relaxation in the EICS pressure at 5 minutes of running.Method: 142 patients with increased pressure completed a questionnaire. 93 of these patients have had a fasciotomy of the anterior (67) or deep posterior compartment (26). A 'excellent' and 'good' result were a successful outcome, 'fair' and 'poor' were a non-successful outcome. Results: The rate of success was 51% for patients surgically treated for anterior compartment and 54% for the deep posterior compartment. At the anterior compartment the sensitivity and specificity of the Pedowitz-criteria were respectively 97% and 17% and at the deep posterior compartment resp. 100% and 6%. The AUC-value of the relaxation pressure was <0,601 for both compartments. Discussion: The success rate of the fasciotomy of the anterior compartment is low. However, comparing these results with other studies is challenging given the different in- and exclusion criteria, population and outcome measures. The result of the deep posterior compartment were in line with previous research. Nevertheless, this success rate was still disappointing. There was a poor correlation between the measurement of pressure and the success for both the Pedowitz-criteria such as the relaxation pressure during exercise. Conclusion: The results of the fasciotomy of the anterior and deep posterior compartment are disappointing. Therefore, the current reference values of the pressure measurement must be reconsidered.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Berkel, Dr. S. van and Sportgeneeskunde and Isala Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:07 |
| Last Modified: | 25 Jun 2020 11:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2728 |
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