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Related Experiment Videos

Physiological changes in venous hemodynamics associated with elective fasciotomy.

Niten Singh1, Anton N Sidawy, Craig R Bottoni

  • 1Department of Vascular Surgery, Washington Hospital Center, Washington, DC 20010, USA. nhsingh@aol.com

Annals of Vascular Surgery
|April 14, 2006
PubMed
Summary

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Lower extremity fasciotomy for chronic exertional compartment syndrome may impair calf muscle pump function, increasing the risk of chronic venous insufficiency. Further follow-up is needed to confirm long-term effects on venous hemodynamics.

Area of Science:

  • Vascular Surgery
  • Sports Medicine
  • Venous Hemodynamics

Background:

  • Lower extremity fasciotomy is suspected to impair the calf musculovenous pump, potentially leading to chronic venous insufficiency (CVI).
  • Previous studies on trauma patients are limited by confounding injuries and historical controls.
  • This study prospectively evaluates venous hemodynamics after elective fasciotomy for chronic exertional compartment syndrome (CECS).

Purpose of the Study:

  • To assess the impact of elective lower extremity fasciotomy on calf muscle pump function and venous hemodynamics in patients with CECS.
  • To determine if fasciotomy for CECS increases the risk of developing chronic venous insufficiency.

Main Methods:

  • Prospective evaluation of 15 patients (17 limbs) undergoing elective fasciotomy for CECS.

Related Experiment Videos

  • Pre- and post-operative assessment using air plethysmography (APG) and colorflow duplex ultrasonography.
  • Analysis of venous hemodynamics including outflow fraction, venous volume, ejection volume, venous filling index (VFI), ejection fraction, and residual volume fraction (RVF).

    • Main Results:

    • No significant changes in outflow fraction, venous volume, or ejection volume were observed.
    • A significant increase in venous filling index (VFI) and residual volume fraction (RVF) was noted post-fasciotomy.
    • Ejection fraction showed a trend toward decrease; no deep venous reflux developed, though new superficial venous reflux occurred in three limbs without affecting VFI.

    Conclusions:

    • Elective fasciotomy for CECS does not appear to cause significant venous reflux.
    • Fasciotomy likely diminishes calf muscle pump function and moderately increases RVF in young adults.
    • Longer follow-up is warranted to ascertain if diminished pump function increases the risk of CVI.