Endoscopically Assisted Fasciotomy: Description of Technique and in Vitro Assessment of Lower-Leg Compartment Decompression

We describe a reliable method of endoscopically assisted fasciotomy for treating chronic exertional compartment syndrome in the lower leg and for assessing compartment decompression in an in vitro model. Endoscopically assisted fasciotomy was performed in the anterior and lateral compartments of 14...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of sports medicine 2002-03, Vol.30 (2), p.272-278
Main Authors: Leversedge, Fraser J., Casey, Patrick J., Seiler, John G., Xerogeanes, John W.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Compartment syndrome
Compartment syndromes
Compartment Syndromes - surgery
Decompression, Surgical
Endoscopic surgery
Endoscopy
Fasciotomy
Humans
Legs
Medical sciences
Methods
Orthopedic surgery
Sports injuries
Sports medicine
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We describe a reliable method of endoscopically assisted fasciotomy for treating chronic exertional compartment syndrome in the lower leg and for assessing compartment decompression in an in vitro model. Endoscopically assisted fasciotomy was performed in the anterior and lateral compartments of 14 matched, fresh-frozen, through-the-knee amputation specimens using a 30° endoscope. A one-incision technique used in 4 specimens failed to provide complete visualization, and a two-incision technique was then performed in 10 specimens. After decompression, the skin and subcutaneous tissues were removed to assess adequacy of release, nerve decompression, anatomic course of the superficial peroneal nerve, and potential complications. Endoscopic visualization of the fascial layer and subcutaneous neurovascular structures permitted consistent compartment decompression. Fascial release, expressed as a percentage of length from the proximal origin of the fascia to the inferior retinaculum, was 99.8% (range, 98.4% to 100%) for the anterior compartment and 96.4% (range, 82% to 100%) for the lateral compartment. There were no retained fascial bands, unrecognized fascial defects, or neurovascular injuries. Optimal visualization with endoscopically assisted fasciotomy may improve clinical outcome through 1) reliable compartment decompression, 2) identification of fascial defects, 3) decompression of nerve branches at the fascial foramen, and 4) reduction of iatrogenic risk to neurovascular and muscular structures.
ISSN:0363-5465
1552-3365
DOI:10.1177/03635465020300022101