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Fasciotomy after trauma to the extremities
D V Feliciano1, P A Cruse, V Spjut-Patrinely
1Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas 77030.
American Journal of Surgery
|December 1, 1988
Summary
Fasciotomy after trauma is crucial for preventing lower extremity amputations, with delays or incomplete procedures leading to poor outcomes. Proper technique is essential for effective decompression in both upper and lower extremities.
Area of Science:
- Trauma surgery
- Orthopedic surgery
- Vascular surgery
Background:
- Compartment syndrome is a surgical emergency following trauma.
- Fasciotomy is a key intervention to relieve pressure and restore blood flow.
- Understanding fasciotomy indications and outcomes is vital for patient management.
Purpose of the Study:
- To analyze the indications, techniques, and outcomes of fasciotomy in trauma patients.
- To evaluate the effectiveness of fasciotomy in preventing amputations.
- To identify factors associated with successful and unsuccessful fasciotomy outcomes.
Main Methods:
- Retrospective review of 122 patients undergoing fasciotomy over 9 years.
- Analysis of indications, timing, surgical technique, and complications.
- Correlation of fasciotomy timing and completeness with amputation rates.
Main Results:
- Fasciotomy was most common in lower extremities after vascular trauma.
- Delayed or incomplete fasciotomy was associated with 75% of lower extremity amputations.
- Specific compartment decompression varied between upper and lower extremities; direct suture closure was common.
Conclusions:
- Timely and complete fasciotomy is critical for limb salvage in trauma patients.
- Inadequate decompression, particularly in the upper extremity, requires further investigation.
- Standardized fasciotomy techniques may improve outcomes and reduce amputation rates.