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Wheeless' Textbook of Orthopaedics

Scientific Papers: Fasciotomy After *Trauma* to the Extremities


Feliciano-David-V. Cruse-Pamela-A-P-A. Spjut-Patrinely-Vicky. Surgical Congress, Phoenix, Arizona, April 10-13, 1988. The American Journal of Surgery. 1988 Dec. 156(6). pp 533-536. AB Over a 9-year period, fasciotomy for presumed compartmental syndromes after *trauma* was performed in 25 upper extremities and 100 lower extremities in 122 patients. This procedure was most commonly indicated after vascular injuries in the lower extremities. Twenty percent of patients un derwent fasciotomy before vascular repair. Nineteen percent of patients with vascular injuries in the lower extremities had fasciotomies performed at reoperation. Seventy-five percent of amputations in the lower extremities were related to a delay in performing fasciotomy or an incomplete fasciotomy. Upper-extremity fasciotomies most commonly did not decompress the deep component of the volar compartment, whereas lower extremity fasciotomies without fibulectomy most commonly decompressed all four below-knee compartments. Fasciotomy sites were closed by direct suture in more than half of the patients.



Original Text by Clifford R. Wheeless, III, MD.