Chronic Compartment Syndrome and Surgery — Are patients being tested correctly for this condition? How are your patients tested?

The authors respond to Dr van Rensburg’s letter published in the blog post below.

Letter from Dr. Hislop:

Dear Christa,

The 2 articles were written as a Head to Head– (see link to papers on how to test for compartment syndrome). Dr Hutchinson and I contrast our approaches to the case of the patient with chronic leg pain of compartment syndrome. My approach is more ‘minimalist’ ie no need for resting pressures, test only symptomatic compartments etc. We both put forward the reasons for our opposing views on how pressure testing should be done.

At the end of the day there is no hard evidence base to contradict either approach, and much more study is needed. Until then the authors will no doubt continue to use their own approach, and you could perhaps find a happy medium.

I hope this helps.

Best regards,

Matthew Hislop

Letter from Dr. Hutchinson:

Dear Dr. DC Janse van Rensburg,

Since the purpose of presenting two experts in the field was to display the varied approaches available in the field that would still be considered standard of care at this time, I believe the goal was accomplished.  I remain steadfast that a thorough approach is wise and prudent, however, I must acknowledge by reading my colleagues counter approach that other alternatives of treating and diagnoses may be available.

I hope the readers, in general, appreciate the point/counter point approach offered by Karim Khan and the British Journal of Sports Medicine as a wonderful avenue for discussion for areas such as this that may be more grey than black and white.

It is unfortunate that any confusion occured with the approach; but I hope that the readers reread both articles with that concept in mind; then they can be less confused and have some firm support for whichever approach they choose.


Mark Hutchinson


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