Trans-Ulnar Single Incision Fasciotomy for Decompression of Forearm Compartment Syndrome: A Cadaveric Study.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Anatomy

Background:

• Acute compartment syndrome (ACS) is a surgical emergency requiring prompt fasciotomy.
• Current forearm fasciotomy techniques lack consensus, often involving volar or combined volar/dorsal incisions.
• A trans-ulnar single incision approach presents a potential alternative for ACS treatment.

Purpose of the Study:

• To investigate the efficacy of a trans-ulnar single incision fasciotomy.
• To determine if this approach decompresses deep volar and dorsal forearm compartments.
• To assess pressure reduction to below 30 mmHg in a cadaveric ACS model.

Main Methods:

• Ten fresh, frozen cadaveric upper extremities were used.
• Acute compartment syndrome was simulated by injecting egg whites and measuring compartment pressures.
• A single trans-ulnar incision was performed, followed by blunt dissection and post-fasciotomy pressure measurements.

Main Results:

• ACS was successfully simulated in all specimens.
• The mean operative time was 10.1 minutes.
• Post-fasciotomy pressures averaged 7.1 mmHg (deep volar) and 9.4 mmHg (dorsal), significantly below the 30 mmHg threshold.

Conclusions:

• The trans-ulnar single incision fasciotomy effectively decompressed both deep volar and dorsal forearm compartments.
• This technique successfully reduced compartment pressures below the clinical threshold of 30 mmHg.
• The trans-ulnar approach is a viable option for treating compartment syndrome in cadaveric forearms.