Effect of early fasciotomy on intramuscular pressure and electrical excitability of muscles in experimental compartment syndrome

Abstract

Experiments on rabbits with compartment syndrome of the leg showed that the main pathogenetic factors of muscle injury are postischemic contracture leading to extravascular microcirculatory disorders and tissue necrosis(early postcompression period) and progressive subfascial edema (18 h-4 days). Therapeutic effect of fasciotomy in the early period consists in restoration of bloodflow due to relaxation of contracted muscles and in the late period in decompression of edematous muscles and prevention of secondary ischemia. Fasciotomy through a small section does not lead to sufficient relaxation of rigid muscles and does not essentially increase the subfascial volume. Fasciotomy decreases subfascial pressure and muscle excitability threshold, however they remain considerably elevated during day 1. An electrodiagnostic test is proposed for early (before subfascial edema) detection of postischemic contracture.