Name of the Procedure:

Decompression Fasciotomy, Thigh and/or Knee, 1 Compartment (Flexor or Extensor or Adductor)

Summary

In this procedure, a surgeon makes incisions in the fascia (the connective tissue covering muscles) of the thigh or knee to relieve pressure in a specific muscle compartment. This is done to prevent or treat severe complications from compartment syndrome.

Purpose

Decompression fasciotomy addresses compartment syndrome, a condition where increased pressure within a muscle compartment impedes blood flow and can cause muscle and nerve damage. The goal is to relieve pressure, restore proper blood flow, and prevent muscle and tissue damage.

Indications

• Severe pain in the thigh or knee that is not relieved by pain medications
• Swelling, tightness, and decreased function of the affected limb
• Symptoms of compartment syndrome, such as warm skin, numbness, and tingling
• Worsening of symptoms after injury, surgery, or intense physical activity

Preparation

• Patients may need to fast for several hours before the surgery.
• Blood tests, imaging studies, and possibly compartment pressure measurements will be performed.
• Adjustments to medications, especially blood thinners, might be necessary as directed by the healthcare provider.

Procedure Description

1. The patient is positioned to provide access to the affected thigh or knee compartment.
2. General or regional anesthesia is administered, depending on the specific case.
3. The surgeon makes an incision to expose the fascia covering the muscles.
4. The fascia is carefully incised to relieve pressure.
5. Surgeons might observe for any damaged tissues and perform necessary repair.
6. Layers are closed, and the incision site is dressed.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity and any additional repair needed.

Setting

Decompression fasciotomy is performed in a hospital or surgical center, often in an operating room setting to ensure sterility and access to specialized equipment.

Personnel

• Orthopedic or general surgeons
• Nurses and surgical technicians
• Anesthesiologists or nurse anesthetists
• Radiologists (if imaging is needed intraoperatively)

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Recurrence of compartment syndrome
• Scarring
• Blood clots
• Longer-term complications like chronic pain or altered muscle function

Benefits

• Relief from severe pain and pressure
• Prevention of permanent muscle and nerve damage
• Improved limb function and mobility following recovery
• Immediate relief of symptoms can often be realized post-surgery

Recovery

• Initial recovery in a hospital with monitoring for signs of complications
• Pain management with medication as needed
• Instructions for wound care and limiting physical activity
• Physical therapy may be recommended to restore full function
• Follow-up appointments to monitor healing and remove any sutures

Alternatives

• Non-surgical treatments like rest, anti-inflammatory medications, and physical therapy (often less effective for severe cases)
• Other surgical options may be considered, depending on the individual case and location of pressure build-up

Patient Experience

• During the procedure, patients will be under anesthesia and not feel pain.
• Post-procedure, there might be pain and discomfort at the incision site managed by prescribed medications.
• Physical therapy and gradual return to normal activities are typical during recovery.
• Patients should report any unusual symptoms like increased pain, redness, or swelling to their healthcare provider immediately.