Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral
CPT4 code
Name of the Procedure:
Decompression Fasciotomy of the Pelvic (Buttock) Compartment(s)
Summary
Decompression fasciotomy of the pelvic compartments is a surgical procedure aimed at relieving pressure in the buttock muscles, specifically targeting the gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscles on one side of the body.
Purpose
The procedure addresses conditions like compartment syndrome, where increased pressure within the muscles leads to pain and potential muscle damage. The goal is to relieve this pressure, improve blood flow, reduce pain, and prevent long-term damage to the affected muscles and nerves.
Indications
- Symptoms of compartment syndrome such as severe pain, swelling, and loss of function in the buttock area.
- Diagnostic tests indicating increased pressure in the muscle compartments.
- Patients who have not responded to non-surgical treatments.
Preparation
- Patients may need to fast for several hours before the procedure.
- Adjustments to current medications may be required, especially blood thinners.
- Preoperative assessments might include imaging tests like MRI or CT scans, and measurement of compartment pressures.
Procedure Description
- The patient is given general or regional anesthesia.
- The surgeon makes an incision in the skin over the affected muscle compartments.
- Fascia (the tough connective tissue surrounding the muscle) is carefully cut to release pressure.
- Any damaged or non-viable tissue may be removed to prevent future complications.
- The incision is closed with sutures or staples, and a sterile dressing is applied.
Tools and Equipment:
- Scalpel
- Surgical scissors
- Forceps
- Suturing materials
- Sterile dressing
Duration
The procedure typically takes around 1-2 hours, depending on the complexity and extent of the decompression needed.
Setting
The procedure is performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic surgeon or general surgeon with expertise in fasciotomies
- Surgical nurses
- Anesthesiologist
Risks and Complications
- Infection
- Bleeding
- Damage to surrounding tissues, nerves, or blood vessels
- Scarring
- Delayed healing
- Recurrence of symptoms
Benefits
- Relief of pain and pressure in the affected muscles
- Restoration of muscle function
- Prevention of long-term complications such as muscle or nerve damage
- Improved mobility and quality of life
Recovery
- Patients may need to stay in the hospital for a short period for monitoring.
- Pain management includes prescribed medications.
- Keeping the incision clean and dry to prevent infection.
- Limited physical activity initially, gradually resuming normal activities as advised by the doctor.
- Physical therapy may be recommended.
- Follow-up appointments for wound check and suture removal.
Alternatives
- Non-surgical treatments such as physical therapy, anti-inflammatory medications, and rest.
- Minimally invasive decompression techniques.
- Each alternative has its own set of pros and cons, with varying effectiveness and recovery times.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel pain. Postoperatively, there may be soreness and some discomfort at the incision site, managed with medications. Patients will need to follow recovery guidelines and attend follow-up visits to ensure proper healing.