Surgery & Perioperative/Emergency / orthopaedic

Emergency fasciotomy

also: compartment syndrome surgery · fasciotomy

Overview

Surgical decompression of a muscle compartment — the emergency treatment of compartment syndrome.

Mechanism

Incision of the fascia to release the raised intra-compartmental pressure → restores perfusion and prevents irreversible muscle/nerve ischaemia (and the rhabdomyolysis/AKI that follow).

Indications

Acute compartment syndrome (a surgical emergency)

Adverse effects

Muscle necrosis / limb loss if delayedserious

Rhabdomyolysis → AKIserious

Wound needs delayed closure/graftcommon

Cautions & contraindications

Delay for investigationsall

Clinical diagnosis — do not wait; time-critical.

Choosing it

Severe pain out of proportion, worse on passive stretch, in a swollen tense limb after fracture/crush — pain not relieved by analgesia.

Source: BOAST — Compartment syndrome