HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leversedge, F. J. Articles by Xerogeanes, J. W. Search for Related Content PubMed PubMed Citation Articles by Leversedge, F. J. Articles by Xerogeanes, J. W. Related Collections Muscle Arthroscopy

Endoscopically Assisted Fasciotomy

Description of Technique and In Vitro Assessment of Lower-Leg Compartment Decompression

Fraser J. Leversedge, MD^*,, Patrick J. Casey, MD^*, John G. Seiler, III, MD^*, and John W. Xerogeanes, MD^*

^* Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia
Georgia Hand and Microsurgery, Atlanta, Georgia

Address correspondence and reprint requests to Fraser J. Leversedge, MD, Hand Surgery Associates, 2535 South Downing, Suite 500, Denver, CO 80210

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° 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.

This article has been cited by other articles:

				A. A. Schepsis, M. Fitzgerald, and R. Nicoletta Revision Surgery for Exertional Anterior Compartment Syndrome of the Lower Leg: Technique, Findings, and Results Am. J. Sports Med., July 1, 2005; 33(7): 1040 - 1047. [Abstract] [Full Text] [PDF]

				R. F. Pell IV, H. S. Khanuja, and G. R. Cooley Leg Pain in the Running Athlete J. Am. Acad. Ortho. Surg., November 1, 2004; 12(6): 396 - 404. [Abstract] [Full Text] [PDF]

				E Cetinus, M Uzel, E Bilgic, A Karaoguz, and M Herdem Exercise induced compartment syndrome in a professional footballer Br. J. Sports Med., April 1, 2004; 38(2): 227 - 229. [Abstract] [Full Text] [PDF]

				K. Bhattacharya and A. N. Catherine Acute Compartment Syndrome of the Lower Leg: Changing Concepts International Journal of Lower Extremity Wounds, December 1, 2003; 2(4): 240 - 242. [Abstract] [PDF]

				M. R. Hutchinson, B. Bederka, and M. Kopplin Anatomic Structures at Risk During Minimal-Incision Endoscopically Assisted Fascial Compartment Releases in the Leg Am. J. Sports Med., September 1, 2003; 31(5): 764 - 769. [Abstract] [Full Text] [PDF]

				M. J. Fraipont and G. J. Adamson Chronic Exertional Compartment Syndrome J. Am. Acad. Ortho. Surg., July 1, 2003; 11(4): 268 - 276. [Abstract] [Full Text] [PDF]