Name of the Procedure:

Decompression Fasciotomy, Leg; Posterior Compartment(s) Only

Summary

A decompression fasciotomy for the posterior compartment of the leg is a surgical procedure that involves making incisions in the muscle fascia to relieve pressure and improve blood flow. This procedure helps in treating conditions caused by swelling or compartment syndrome.

Purpose

This procedure addresses compartment syndrome, a serious condition where pressure within the muscles builds to dangerous levels, leading to decreased blood flow and muscle damage. The goal is to relieve this pressure to prevent permanent muscle or nerve damage.

Indications

• Symptoms of compartment syndrome such as severe pain, swelling, and tightness in the calf.
• Loss of sensation or movement in the affected leg.
• Known trauma or injury leading to muscle swelling and increased compartment pressure.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjustments to regular medications as instructed by your healthcare provider.
• Pre-operative assessments including blood tests, imaging studies (e.g., MRI, CT scan), and physical examinations.

Procedure Description

1. Anesthesia: The patient is given regional or general anesthesia to ensure comfort.
2. Incisions: The surgeon makes long incisions in the skin over the posterior compartment of the leg.
3. Fascia Release: The fascia, a tough connective tissue surrounding muscles, is carefully cut to relieve pressure.
4. Closure: The incisions may be left partially open or loosely closed to accommodate swelling; a vacuum-assisted closure device may sometimes be used.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

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

Personnel

• Orthopedic or general surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection
• Persistent swelling or pain
• Nerve or blood vessel damage
• Scarring and cosmetic concerns
• Compartment syndrome recurrence

Benefits

• Relieves pressure and pain in the affected leg compartment.
• Prevents muscle and nerve damage.
• Restores normal blood flow and function in the leg.

Recovery

• Pain management through prescribed medications.
• Keeping the leg elevated and reducing activity to limit swelling.
• Wound care instructions to prevent infection.
• Follow-up appointments for monitoring recovery progress.
• Physical therapy may be required to regain strength and mobility.

Alternatives

• Non-surgical treatments such as rest, ice, compression, and elevation (RICE), though they may be insufficient for severe cases.
• Minimally invasive techniques like needle fasciotomy, but these have limitations in effectiveness.
• Observation and delayed intervention, which could lead to worsening symptoms or complications.

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. Post-procedure, the patient may experience pain and discomfort, manageable with medications. It is common to feel swelling and see bruising, and it’s crucial to follow aftercare instructions for optimal recovery.