The mechanism and acuity of the compartment syndrome will directly relate to the urgency to go to the operating room. Once compartment syndrome is diagnosed, surgical fasciotomy is the standard treatment. What is the urgency of the surgery? What is the risk of delay in order to obtain additional preoperative information? The two-incision technique is more common, with the latter incision made longitudinally approximately 2 cm anterior to the fibular shaft and the medial incision made longitudinally 1 to 2 cm posterior to the subcutaneous posteromedial border of the tibia.ġ. The fasciotomy of the lower leg can be done with either a single incision or two incisions. The lower leg has four compartments: anterior, lateral, superficial posterior, and deep posterior. Muscle necrosis will occur within 3 hours of the onset of ischemia with irreversible muscle and nerve damage occurring within 5 hours.Ĭompartment syndromes of the lower extremity most frequently occur below the knee. These are often true emergencies with the time from diagnosis to fasciotomy critical to help prevent muscle ischemia and necrosis. Acute compartment syndromes in the lower extremity most frequently result from traumatic insult, but can also be associated with reperfusion after ischemic injury, burns, or prolonged surgical positioning (lithotomy).

What the Anesthesiologist Should Know before the Operative Procedureĭecompressive fasciotomy of the lower leg is most frequently performed to relieve acute compartment syndromes.

Compartments of leg