Vascular

Fasciotomy, Lower Limb (Four-Compartment)

OPERATION: Lower Limb Four-Compartment Fasciotomy
ANAESTHETIC: General / regional anaesthesia
POSITION: Supine, saline bag support under knee.

INDICATION:
Compartment syndrome of the lower limb — [post-revascularisation / trauma / crush injury]. Clinical diagnosis: pain out of proportion, pain on passive stretch, tense compartments. [Compartment pressure >30 mmHg measured]. Peripheral pulses may be present.

PROCEDURE:
WHO Checklist performed. Two longitudinal skin incisions made — anterolateral and posteromedial.

ANTEROLATERAL INCISION:
Incision midway between tibial tuberosity and fibula, extended to lateral malleolus. Fascia over anterior and lateral compartments exposed. Intermuscular septum identified. Anterior compartment fasciotomy — fascia incised longitudinally from tibial tuberosity to ankle. Lateral compartment fasciotomy — fascia incised parallel to fibula, superficial peroneal nerve protected throughout.

POSTEROMEDIAL INCISION: