A practical approach to compartmental syndrome. Part III. Management

Early diagnosis and appropriate treatment of an established compartment syndrome usually results in a functional extremity for the patient. In my experience, the commonest causes for failure of a fasciotomy are (1) delay in initiation of the operative procedure and (2) an incomplete fasciotomy. Thorough knowledge of the anatomy of the upper and lower extremity should allow the surgeon to confidently decompress any compartment with relative ease and safety for the patient. Most of these extremities have already suffered closed blunt trauma, and many are associated with an underlying fracture. It is mandatory that the surgeon minimize the operative trauma by careful handling of soft tissue and expeditious fixation of a coexistent fracture.