Upper extremity fasciotomy

Abstract

Compartment syndrome results from the combination of increased interstitial tissue pressure and the noncompliant nature of the fascia and osseous structures that make up a fascial compartment, causing microvascular compromise and subsequent muscle and nerve ischemia. Nerve conduction can be negatively affected after 2 h of ischemia; however, if compartment syndrome is diagnosed and treated within 6 h of onset, overall functional impairment is unlikely. Diagnosis of compartment syndrome can be made by clinical examination or with more objective measurements such as compartment pressures. Fasciotomy is indicated once the clinical diagnosis of compartment syndrome is made. It consists of one or more fascial incisions and remains the only effective way to treat acute compartment syndrome. Compartments that have the least baseline compliance are those that are most likely to develop compartment syndrome. Although it most commonly occurs in the compartments at the level of the tibia and fibula, compartment syndrome is seen in any enclosed muscle group, including the upper extremity.