Name of the Procedure:

Decompression Fasciotomy, Forearm and/or Wrist, Flexor and Extensor Compartment; Without Debridement of Nonviable Muscle and/or Nerve

Summary

Decompression fasciotomy is a surgical procedure to relieve pressure in the forearm or wrist compartments. This procedure involves making surgical cuts to release the tight fascia, a connective tissue layer, without removing damaged muscle or nerve tissue.

Purpose

This procedure addresses conditions like compartment syndrome, which occurs when pressure within the muscles builds to dangerous levels, reducing blood flow and potentially leading to muscle and nerve damage. The goal is to restore normal blood flow and prevent further tissue damage.

Indications

• Severe pain unrelieved by medication
• Noticeable swelling and tightness in the forearm or wrist
• Numbness or weakness in the hand
• Diagnosed compartment syndrome through pressure measurements

Preparation

• Fasting for 6-8 hours before surgery
• Adjustments to medications as advised by the healthcare provider
• Pre-operative imaging tests like MRI or CT scan
• Blood tests to ensure the patient is fit for surgery

Procedure Description

1. The patient is placed under general or regional anesthesia.
2. The surgical site is sterilized and prepped.
3. An incision is made in the skin and fascia of the forearm or wrist to expose the muscular compartments.
4. The surgeon makes cuts in the fascia to relieve pressure without removing nonviable muscle or nerve tissue.
5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 1-2 hours.

Setting

The procedure is performed in a hospital or a surgical center.

Personnel

• Orthopedic or trauma surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Nerve damage
• Scarring
• Potential for incomplete relief of symptoms, requiring further surgery

Benefits

• Relieves pain and pressure
• Prevents permanent muscle and nerve damage
• Improves limb function Benefits are usually realized within a few days to weeks post-operatively.

Recovery

• Post-operative pain management with prescribed medication
• Keeping the surgical site clean and dry
• Follow-up appointments for wound check and suture removal
• Physical therapy may be required
• Expect recovery time to last several weeks, with gradual resumption of activities

Alternatives

• Non-surgical options like rest, elevation, and anti-inflammatory medications
• Emergency fasciotomy if the condition worsens rapidly
• Each alternative has its pros and cons, such as slower symptom relief or higher risks if not treated surgically

Patient Experience

During the procedure, the patient will be under anesthesia and not feel any pain. Post-surgery, mild to moderate pain can be expected, which will be managed with medications. The arm may be immobilized initially, and some discomfort can be felt during the healing process.