Compartment Fasciotomy of Lower Extremity: A Review of the Current Understanding

Acute compartment syndrome (ACS) is a time-sensitive orthopedic emergency that requires immediate attention to prevent severe consequences. The lower extremity is a common site for ACS, and its diagnosis relies heavily on precise clinical findings. In this article, we will review the current understanding of compartment fasciotomy in the lower extremity, including its causes, symptoms, and treatment options.

Causes of Compartment Syndrome

Compartment syndrome occurs when increased pressure within a muscle compartment surrounded by a closed fascial space leads to a decline in tissue perfusion and compromises motor and sensory function. This condition can be caused by various factors, including trauma, strenuous exercise, and certain medical conditions. Younger patients, particularly those under the age of 35, are at a higher risk of developing ACS due to their tighter fascia and larger muscle mass.

Symptoms of Compartment Syndrome

The symptoms of compartment syndrome vary depending on the severity of the condition. Hallmark signs include pain, poikilothermia (coldness), pallor (paleness), paresthesia (tingling or numbness), pulselessness, and paralysis. Late findings can lead to limb amputation, contractures, paralysis, multiorgan failure, and even death.

Diagnosis of Compartment Syndrome

Diagnosing compartment syndrome is crucial in preventing severe consequences. Clinicians should perform a thorough physical examination, including checking for signs of numbness, tingling, or weakness in the affected extremity. Laboratory tests, such as complete blood counts and creatine kinase levels, may also be necessary to rule out other conditions.

Treatment Options

The definitive treatment for compartment syndrome is timely fasciotomy, which involves making incisions in the skin and underlying tissue to release pressure and restore perfusion. This procedure should be performed by an experienced orthopedic surgeon as soon as possible after diagnosis.

In conclusion, compartment fasciotomy of the lower extremity is a critical intervention that requires prompt attention. By understanding the causes, symptoms, and treatment options for this condition, healthcare providers can provide timely and effective care to patients suffering from acute compartment syndrome.

Compartment fasciotomy of lower extremity