Endoscopically assisted fasciotomy: description of technique and in vitro assessment of lower-leg compartment decompression.

Published

Journal Article

We describe a reliable method of endoscopically assisted fasciotomy for treating chronic exertional compartment syndrome in the lower leg and for assessing compartment decompression in an in vitro model. Endoscopically assisted fasciotomy was performed in the anterior and lateral compartments of 14 matched, fresh-frozen, through-the-knee amputation specimens using a 30 degrees endoscope. A one-incision technique used in 4 specimens failed to provide complete visualization, and a two-incision technique was then performed in 10 specimens. After decompression, the skin and subcutaneous tissues were removed to assess adequacy of release, nerve decompression, anatomic course of the superficial peroneal nerve, and potential complications. Endoscopic visualization of the fascial layer and subcutaneous neurovascular structures permitted consistent compartment decompression. Fascial release, expressed as a percentage of length from the proximal origin of the fascia to the inferior retinaculum, was 99.8% (range, 98.4% to 100%) for the anterior compartment and 96.4% (range, 82% to 100%) for the lateral compartment. There were no retained fascial bands, unrecognized fascial defects, or neurovascular injuries. Optimal visualization with endoscopically assisted fasciotomy may improve clinical outcome through 1) reliable compartment decompression, 2) identification of fascial defects, 3) decompression of nerve branches at the fascial foramen, and 4) reduction of iatrogenic risk to neurovascular and muscular structures.

Full Text

Duke Authors

Cited Authors

  • Leversedge, FJ; Casey, PJ; Seiler, JG; Xerogeanes, JW

Published Date

  • March 2002

Published In

Volume / Issue

  • 30 / 2

Start / End Page

  • 272 - 278

PubMed ID

  • 11912100

Pubmed Central ID

  • 11912100

International Standard Serial Number (ISSN)

  • 0363-5465

Digital Object Identifier (DOI)

  • 10.1177/03635465020300022101

Language

  • eng

Conference Location

  • United States