27497 Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve

Name of the Procedure:

Decompression Fasciotomy, Thigh and/or Knee, 1 Compartment (Flexor, Extensor, or Adductor) with Debridement of Non-Viable Muscle and/or Nerve

Summary

A decompression fasciotomy is a surgical procedure aimed at relieving pressure in a specific muscle compartment of the thigh or knee. This procedure includes the removal of dead or damaged muscle and nerve tissue to prevent further injury and promote healing.

Purpose

The procedure addresses conditions of increased pressure within a muscle compartment, known as Compartment Syndrome. The main goals are to alleviate pain, restore normal blood flow and preserve muscle and nerve function by reducing the high pressure within the compartment.

Indications

• Symptoms of severe pain, tightness, or swelling in the thigh or knee.
• Diagnosis of acute or chronic Compartment Syndrome.
• Loss of muscle function or sensation in the affected area.
• Non-responsiveness to conservative treatments like rest or medications.

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Medication adjustments might be required, especially for blood thinners.
• Pre-procedure diagnostic tests like MRI or pressure measurements to assess the severity of the condition.

Procedure Description

1. The patient is given anesthesia, usually general or regional.
2. An incision is made in the thigh or knee to access the affected muscle compartment.
3. The surgeon cuts the fascia (connective tissue) to relieve pressure.
4. Non-viable (dead) muscle and nerve tissues are identified and removed.
5. The incision is closed with sutures, and a sterile dressing is applied.

Special tools used include a scalpel, surgical scissors, and possibly specialized instruments to measure compartment pressure.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and extent of tissue damage.

Setting

The procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic or specialized surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and technicians

Risks and Complications

• Infection
• Excessive bleeding
• Nerve damage
• Blood clots
• Incomplete relief of symptoms
• Recurrent Compartment Syndrome

Benefits

• Immediate relief of pressure and pain
• Prevention of permanent muscle and nerve damage
• Restoration of normal function and mobility
• Typically, benefits are realized within days to weeks post-surgery.

Recovery

• Patients may need to stay in the hospital for a few days.
• Pain management with prescribed medications.
• Follow-up appointments to monitor healing and remove sutures.
• Physical therapy may be recommended to regain strength and mobility.
• Full recovery can take several weeks to months.

Alternatives

• Non-surgical treatments: physical therapy, medications, rest.
• Monitoring and conservative management for mild cases.
• Each alternative comes with varied effectiveness and may prolong recovery compared to surgery.

Patient Experience

• Patients might experience post-operative pain and discomfort, managed with medications.
• Possible restrictions on physical activities for several weeks.
• Gradual improvement in symptoms and function following the surgical procedure.
• Emotional and psychological support might be needed for coping with recovery.