Single-Incision 4-Compartment Fasciotomy of the Lower Leg: Safe, Effective, and Advantageous.

Single-Incision 4-Compartment Fasciotomy of the Lower Leg: Safe, Effective, and Advantageous. Orthopedics. 2020 Apr 09;:1-6 Authors: Chang G, Fram B, Krieg JC Abstract The optimal surgical approach for acute compartment syndrome (ACS) of the lower leg remains debatable. Although a majority of surgeons tend to use a 2-incision approach to 4-compartment fasciotomies, the authors have used a single-incision technique followed by protocolized, staged skin closure. The purpose of this study was to determine the safety, efficacy, and complication rate of this strategy. This retrospective study included all patients treated for ACS by a single surgeon during a 3-year period. A protocol was used including a single-incision technique followed by vacuum-assisted wound-closure dressing, periodic return to the operating room at 48- to 72-hour intervals, and sequential wound closure with vertical mattress sutures. Complications associated with this protocol were analyzed. Eleven patients were included in the study. Average length of follow-up was 12 months (range, 2-35 months). There were no instances of malunion, deep or superficial infection, intraoperative neurovascular injury, or progressive neurologic deficits-indicating adequate release of all 4 compartments through a single incision. All patients were closed primarily without need for skin grafting. Average time to primary closure was 4.5 days. One patient had a tibial fracture nonunion an...
Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research