2: Fasciotomy of the Upper Limb

Procedure 2 Fasciotomy of the Upper Limb





Examination/Imaging



Clinical Examination




image Compartment syndrome is caused by increased pressure within the myofascial compartments leading to a decrease in blood flow. Nerves followed by muscle are most sensitive to ischemia and undergo irreversible changes within 6 to 8 hours. It is therefore important to decompress the fascial compartment by performing a fasciotomy and to restore tissue perfusion as soon as possible.


image Compartment syndrome is a clinical diagnosis based on the features of ischemia of nerve (paresthesia, pain, and paralysis), muscle (pain on passive stretch), and vessel (pallor and pulselessness). All features may not be present in every patient, and a diagnosis is made based on the overall clinical scenario.







image A prophylactic fasciotomy should be performed in all major limb replantations/revascularizations irrespective of the clinical appearance of the limb at the end of the procedure (Fig. 2-4). The limb is insensate and becomes progressively swollen as a result of diminished venous return and ischemia reperfusion injury. When a fasciotomy is not performed, the arterial inflow can be compromised, leading to failure of the replantation.







Mar 5, 2016 | Posted by in Hand surgery | Comments Off on 2: Fasciotomy of the Upper Limb

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