The curvature of the crural fascia is different in anterior leg chronic exertional compartment syndrome.

OBJECTIVES: Patients possibly having chronic exertional compartment syndrome of the anterior leg require confirmatory intracompartmental pressure measurements, but this test is invasive, patient unfriendly and imprecise. Ultrasound studies suggested that the morphology of the leg crural fascia covering the muscle might be changed. Aim of this study was to analyse the crural fascia curvature in chronic exertional compartment syndrome of the anterior leg in patients and healthy controls. DESIGN: Observational. METHODS: From February 2023 to February 2024 patients and controls matched for sex, age and body mass index underwent leg imaging with 10 mmHg and 80 mmHg external ultrasound probe pressure. The curvature of the fascia was measured before and after a treadmill test (convex to concave, +40 to -40). RESULTS: 209 ultrasound images in 21 patients (13 males; age 31 ± 11; body mass index 26 ± 5) and 21 controls (13 males; age 36 ± 14; body mass index 24 ± 3) were analysed. With 10 mmHg external pressure, fascia curvature at rest was not different (patients 18.6 ± 4.4 versus controls 17.5 ± 6.3, p = 0.53). After exercise, the fascia was more convex in patients compared to controls (30 s: 26.4 ± 5.8 versus 22.8 ± 5.4, p = 0.05; 5 min: 24.3 ± 4.9 versus 20.1 ± 5.9, p = 0.02). No group curvature differences at 80 mmHg external pressure were found. CONCLUSIONS: Following exercise, the crural fascia in patients with chronic exertional compartment syndrome of the anterior leg is more convex compared to controls.