Fasciotomy for exertional anterior compartment syndrome: Is lateral compartment release necessary?

The standard surgery for exertional anterior compartment syndrome is fascio tomy of the anterior and lateral compartments of the leg. We prospectively studied the necessity of lateral compartment release, which can add morbidi ty and extend recovery. We performed 30 anterior compartment releases in 20 patients (10 bilateral operations) with exertional anterior compartment sy ndrome but no lateral compartment involvement. We alternately performed onl y an anterior compartment release or both anterior and lateral compartment releases on 10 patients. The 10 patients who underwent bilateral surgery ea ch had, during the same surgery, an anterior and lateral compartment releas e on one leg and only an anterior compartment release on the other. All wer e athletes involved in running sports. Overall, satisfactory outcomes were seen in 90% of the limbs-93% (14 of 15) that had anterior compartment relea se and 87% (13 of 15) that had release of both compartments (no statistical ly significant difference). For the patients who had unilateral surgery, th e average time for full return to sports was 8.1 weeks after anterior relea se only and 11.4 weeks after release of both compartments, a statistically significant difference. The average time for full return to sports after bi lateral surgery was 12.1 weeks, Among these patients, seven said that the l eg with only anterior release seemed to recover faster. We concluded that w hen doing a fasciotomy for exertional anterior compartment syndrome alone, a lateral compartment release is not necessary.