CHRONIC COMPARTMENT SYNDROME OF THE QUADRICEPS FEMORIS MUSCLE IN ATHLETES - DIAGNOSIS, IMAGING AND TREATMENT WITH FASCIOTOMY

Background and Aims: Chronic quadriceps femoris muscle compartment syn drome is described. Material and Methods: Over a 13 year period nine p atients were diagnosed, treated surgically by fasciotomy and followed up at a referral center specialized in sports traumatology. There were four power lifters, three body builders, one endurance walker and one cyclist in the series. The use of anabolic steroids was admitted by f our of the nine patients. The patients complained of gradually worseni ng pain on the anterolateral side of the thigh during training. Initia lly the pain appeared only at the end of the training session. As the syndrome became more severe, the pain began earlier during exercise an d gradually became worse preventing maximal training. Skeletal radiogr aphs and ultrasound examinations were normal, except in two patients, who had a positive echography finding with local atrophy. MRI examinat ion confirmed the US diagnosis. Results and Conclusions: As conservati ve treatment did not provide relief of symptoms, a fasciotomy anterior to the iliotibial tract was performed bilaterally to seven patients a nd unilaterally to two patients. Biopsies from the atrophied sites sho wed muscle cell necrosis. All the patients recovered well after the su rgery and were able return to their original level of sport. The only complication of surgery was a postoperative hematoma in one patient, w hich delayed the beginning of the training, but did not result in any persistent complaints.