Histology of the fascial-periosteal interface in lower limb chronic deep posterior compartment syndrome

Barbour, T. D. A., Briggs, C. A., Bell, S. N., Bradshaw, C. J., Venter, D. J. and Brukner, P. D. (2004) Histology of the fascial-periosteal interface in lower limb chronic deep posterior compartment syndrome. British Journal of Sports Medicine, 38 6: 709-717. doi:10.1136/bjsm.2003.007039


Author Barbour, T. D. A.
Briggs, C. A.
Bell, S. N.
Bradshaw, C. J.
Venter, D. J.
Brukner, P. D.
Title Histology of the fascial-periosteal interface in lower limb chronic deep posterior compartment syndrome
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 0306-3674
1473-0480
Publication date 2004-12-01
Sub-type Article (original research)
DOI 10.1136/bjsm.2003.007039
Open Access Status DOI
Volume 38
Issue 6
Start page 709
End page 717
Total pages 9
Place of publication England
Publisher BMJ Publishing Group
Language eng
Subject 110604 Sports Medicine
Abstract Objective: To describe the histological features of the fascial-periosteal interface at the medial tibial border of patients surgically treated for chronic deep posterior compartment syndrome and to make statistical comparisons with control tissue. Methods: Nineteen subjects and 11 controls were recruited. Subject tissue was obtained at operation, and control tissue from autopsy cases. Tissue samples underwent histological preparation and then examination by an independent pathologist. Samples were analysed with regard to six histological variables: fibroblastic activity, chronic inflammatory cells, vascularity, collagen regularity, mononuclear cells, and ground substance. Collagen regularity was measured with respect to collagen density, fibre arrangement, orientation, and spacing. The observed changes were graded from 1 to 4 in terms of abnormality. Mann-Whitney U test, Spearman correlation coefficients, and intraobserver reliability scores were used. Results: With regard to collagen arrangement, control tissue showed greater degrees of irregularity than subject tissue (p = 0.01). Subjects with a symptom duration of greater than 12 months (as opposed to less than 12 months) showed greater degrees of collagen irregularity (p = 0.043). Vascular changes approached significance (p = 0.077). With regard to the amount of fibrocyte activity, chronic inflammatory cell activity, mononuclear cells, or ground substance, there were no significant differences between controls and subjects. Good correlation was seen in scores measuring chronic inflammatory cell activity and mononuclear cells (r = 0.649), and moderate correlation was seen between fibrocyte activity and vascular changes (r = 0.574). Intraobserver reliability scores were good for chronic inflammatory cell activity and moderate for vascular changes, but were poor for collagen and fibrocyte variables. Individual cases showed varying degrees of fibrocyte activity, chronic inflammatory cellular infiltration, vascular abnormalities, and collagen fibre disruption. Conclusions: Statistical analysis showed no histological differences at the fascial-periosteal interface in cases of chronic deep posterior compartment syndrome, except for collagen, which showed less irregularity in subject samples. The latter may indicate a remodelling process, and this is supported by greater collagen irregularity in subjects with longer duration of symptoms.
Keyword Sports medicine
chronic exertional compartment syndrome
fascia
periosteum
histology
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Human Movement and Nutrition Sciences Publications
 
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Created: Sat, 04 Apr 2009, 00:13:39 EST by Ms Karen Naughton on behalf of School of Human Movement and Nutrition Sciences