Abstract des Autors

Chronic stress syndrome of the anterior and lateral aspect of the leg is one of the most common causes of pain in the athlete, especially runners. High intramuscular pressure is a key element of the pathophysiology and is caused by an imbalance between increased muscle volume at exertion and the inextensibility of the muscle compartment. High pressures, above a critical threshold of 30 mm Hg produce a viscious circle which does not stop until exercise is ceased. This explains the painful syndrome in active athletes which progressively regresses when exertion is interrupted but which reappears for equivalent stress. Acute forms may require emergency surgery. At rest, there are no clinical signs excepting possible muscular hernia. Pressure measurements during exercise provide evidence not simply by the recorded pressure, but also by the fact that pressure regresses too slowly after interrupting exercise. Among the possible complementary examinations, scintigraphy provides the most information allowing differential diagnosis. There is no "medical" treatment. Surgery with subcutaneous aponevrotomy (or aponevrectomy?) is indicated if the athlete desires continuing his activity. Good or excellent results are obtained in 90% of the cases. Verf.-Referat