Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. May 18, 2021; 12(5): 320-328
Published online May 18, 2021. doi: 10.5312/wjo.v12.i5.320
Endoscopic fasciotomy for chronic exertional compartment syndrome of the forearm: Systematic review of outcomes and complications
Yousef Marwan, Abdullah Addar, Nizar Algarni, Nabil Algarni, Mark Burman, Paul A Martineau
Yousef Marwan, Abdullah Addar, Nizar Algarni, Mark Burman, Paul A Martineau, Division of Orthopaedic Surgery, McGill University Health Centre, Montreal H3G-1A4, Quebec, Canada
Nabil Algarni, Department of Orthopaedic Surgery, King Fahad Medical City, Riyadh 00966, Saudi Arabia
Author contributions: Marwan Y, Addar A and Algarni N participated in all steps of the project, including planning, literature search, data extraction, data analysis, data interpretation and manuscript preparation; Algarni N participated in planning, data analysis, data interpretation and manuscript preparation; Burman M and Martineau PA supervised all steps of the project; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yousef Marwan, BM BCh, BSc, FRCSC, Academic Fellow, Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Avenue, B5-159.6, Montreal H3G-1A4, Quebec, Canada. yousefmarwan@hotmail.com
Received: January 19, 2021
Peer-review started: January 19, 2021
First decision: February 15, 2021
Revised: February 18, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: May 18, 2021
Abstract
BACKGROUND

Endoscopic fasciotomy of the forearm for chronic exertional compartment syndrome (CECS) has gained popularity recently.

AIM

To systematically review the literature of endoscopic fasciotomy for CECS of the forearm, aiming to assess the outcomes and complications of the different endoscopic fasciotomy techniques described in the literature.

METHODS

On January 18, 2021, PubMed and EMBASE were searched by 3 reviewers independently, and all relevant studies published up to that date were considered based on predetermined inclusion/exclusion criteria. The subject headings “endoscopic fasciotomy” and “compartment syndrome” and their related key terms were used. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses statement was used to screen the articles.

RESULTS

A total of seven studies including 183 patients (355 forearms) were included. The mean age of the patients was 31.2 years (range: 15-42 years). The postoperative follow-up duration ranged from 6 wk to 4.9 years. All patients were able to return to sport activities between postoperative weeks 1 to 8. Recurrence of the compartment syndrome occurred in three patients, giving a rate of 1.6% per patient and 0.8% per forearm. The overall complication rate was 8.7% per patient, and 4.5% per forearm. The most common reported complication was hematoma (7 forearms; 2.0%).

CONCLUSION

Endoscopic fasciotomy for CECS of the forearm has favorable short- and mid-term outcomes with very low recurrence and complication rates. This, however, needs to be confirmed in larger, long-term follow-up, prospective, comparative studies between open, mini-open and endoscopic fasciotomy techniques.

Keywords: Exertional compartment syndrome, Compartment syndrome, Fasciotomy, Forearm, Endoscopy

Core Tip: Endoscopic fasciotomy of the forearm for chronic exertional compartment syndrome (CECS) has gained popularity recently. This study reviewed the literature of endoscopic fasciotomy for CECS of the forearm, summarizing the outcomes and complications of the different endoscopic fasciotomy techniques described.