Fasciotomy: a call for proper placement

Abstract

Introduction: It is important that acute compartment syndrome is recognised and treated early. Treatment involves surgical decompression and it is imperative that this is performed in a timely and appropriate manner. The knowledge of plastic and orthopaedic surgery trainees of the safe technique for performing lower leg fasciotomy was examined.

Methods: Survey of knowledge of fasciotomy was performed amongst plastic and orthopaedic surgery trainees. They were asked to fill in a questionnaire during a regional teaching session.

Results: There were 29 respondents; 19 plastic surgery trainees and 10 from orthopaedic surgery. Most trainees had little experience of watching, assisting or performing fasciotomies. When asked to mark the placement of fasciotomy incisions and plane of dissection, only 47% of plastic and 10% of orthopaedic surgery trainees were correct.

Discussion: Clinical experience and knowledge of lower leg fasciotomy is poor amongst trainees surveyed. In this paper, the pathophysiology, diagnosis and treatment of compartment syndrome are described. Examples of poorly placed fasciotomy incisions, as well as the consequences of these, are also presented.