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- Title
Acute Extremity Compartment Syndrome and the Role of Fasciotomy in Extremity War Wounds.
- Authors
Gordon, Wade T; Talbot, Max; Shero, John C; Osier, Charles J; Johnson, Anthony E; Balsamo, Luke H; Stockinger, Zsolt T
- Abstract
Acute compartment syndrome (CS) is a frequent and potentially devastating complication of blunt and penetrating extremity injuries. Extremity war injuries are particularly susceptible to CS due to associated vascular injuries; high Injury Severity Score; extensive bone and soft tissue injury; and frequent transportation that may limit close monitoring of the injured extremity. Treatment consists of prompt fasciotomy of all compartments in the involved segment, over their full length. Delayed or incomplete fasciotomy is associated with worse outcomes, including muscle necrosis, infection, and amputation. Enhanced pre-deployment training of surgeons decreases the need for revision fasciotomy at higher echelons of care and should be continued in future conflicts. We recommend the liberal use of prophylactic fasciotomy prior to aeromedical evacuation and after limb reperfusion. For leg fasciotomy, we recommend a two-incision approach as it is more reproducible and allows easy vascular exposure when necessary.
- Subjects
COMPARTMENT syndrome; BLUNT trauma; INJURIES of the anatomical extremities; FASCIOTOMY; TREATMENT effectiveness; REPERFUSION; EXTREMITIES (Anatomy) -- Surgery; LIMB salvage; OPERATIVE surgery; RETROSPECTIVE studies
- Publication
Military Medicine, 2018, Vol 183, p108
- ISSN
0026-4075
- Publication type
journal article
- DOI
10.1093/milmed/usy084