After positioning the patient supine on the operating table with the operative extremity prepared and draped, anatomic landmarks are identified on the patient's skin. We utilize a technique that allows the surgeon to perform anterior and lateral compartment fasciotomies through a single incision while safely identifying the superficial peroneal nerve. 2010 53:329–34.Surgical release of the anterior and lateral compartments of the lower leg has been shown to relieve the symptoms of chronic exertional compartment syndrome. Current thinking about acute compartment syndrome of the lower extremity. Wound closure of leg fasciotomy: comparison of vacuum-assisted closure versus shoelace technique. Kakagia D, Karadimas EJ, Drosos G, Ververidis A, Trypsiannis G, Verettas D. Primary closure of wide fasciotomy and surgical wounds using rubber band–assisted external tissue expansion: a simple, safe, and cost-effective technique. Kenny EM, Egro FM, Russavage JM, Spiess AM, Acartürk TO. Delayed primary closure of fasciotomy incisions in the lower leg: do we need to change our strategy? J Orthop Trauma. Weaver MJ, Owen TM, Morgan JH, Harris MB. Secondary wound closure following fasciotomy for acute compartment syndrome increases intramuscular pressure. Comparison of fasciotomy wound closures using traditional dressing changes and the vacuum-assisted closure device. New techniques in wound management: vacuum-assisted wound closure. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Analysis of single-incision versus dual-incision fasciotomy for tibial fractures with acute compartment syndrome. A single-incision fasciotomy for compartment syndrome of the lower leg. The efficacy of a single-incision versus two-incision four-compartment fasciotomy of the leg: a cadaveric model. Acute compartment syndrome – who is at risk? J Bone Joint Surg-Br Vol. Ischaemic contracture: experimental study. Accuracy in the measurement of compartment pressures: a comparison of three commonly used devices. Elevated intramuscular compartment pressures do not influence outcome after tibial fracture. White TO, Howell GE, Will EM, Court-Brown CM, McQueen MM. Tissue pressure measurements as a determinant for the need for fasciotomy. Whitesides TE, Haney TC, Morimoto K, Harada H. Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter. Mubarak SJ, Owen CA, Hargens AR, Garetto LP, Akeson WH. The pathophysiology, diagnosis and current management of acute compartment syndrome. Normal compartment pressures of the lower leg in children. Staudt JM, Smeulders MJC, van der Horst CMAM. Diagnosis and treatment of acute extremity compartment syndrome. Von Keudell AG, Weaver MJ, Appleton PT, et al. Acute compartment syndrome of the upper extremity. Acute compartment syndrome of the extremities: an update. Acute compartment syndrome in children: contemporary diagnosis, treatment, and outcome. Acute compartment syndrome: update on diagnosis and treatment. Compartment monitoring in tibial fractures. Diagnosing acute compartment syndrome: are current textbooks misleading? Curr Orthop Pract. Oron A, Netzer N, Rosinsky P, Elmaliache D, Ben-Galim P. Die ischaemischen Muskellahmungen und-Kontrakturen. Intracompartmental pressure monitor system.Many fasciotomy wounds are unable to achieve delayed primary closure and undergo a split-thickness skin graft. Research articles continue to evaluate different and new surgical techniques to improve when delayed primary wound closure can occur. Fasciotomy of the involved compartments continues to be the widely accepted treatment of acute compartment syndrome, but it is not free from complications. A more complete pathophysiological understanding has led to improved education regarding early and late signs/symptoms to reduce delays in diagnosis which currently is subjective to physical exam findings. Delays in diagnosing acute compartment syndrome have been largely discussed in the literature with researchers evaluating new ways to enhance diagnosis. ACS is a surgical emergency that requires timely diagnosis and treatment in order to prevent further irreversible ischemic injuries and long-term morbidity. Acute compartment syndrome (ACS) is defined as a progression of increasing interstitial pressure within a closed fascial compartment resulting in decreasing profusion to the tissues within the compartment which over time causes ischemic injury including muscle necrosis, irreversible nerve damage, contractures, and loss of limb.
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