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Fasciotomy or fasciectomy is a surgical procedure where the fascia is cut to relieve tension or pressure in order to treat the resulting loss of circulation to an area of tissue or muscle. [1] Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome. It is also sometimes used to treat chronic compartment stress syndrome.
A study showed the fasciotomy rate for acute compartment syndrome ranges from 2% to 24%. [19] The key factor in acute compartment syndrome is the time to diagnosis and fasciotomy. [12] A missed or late diagnosis may require limb amputation to survive. [63] [13] After a fasciotomy, some symptoms may be permanent. [13]
The major tissues affected are nerves and muscles, where irreversible damage starts to occur after 4–6 hours of cessation of blood supply. [4] Skeletal muscle, the major tissue affected, is still relatively resistant to infarction compared to the heart and brain because its ability to rely on anaerobic metabolism by glycogen stored in the cells may supply the muscle tissue long enough for ...
Often, multiple incisions are made and left open until the swelling has reduced. At that point, the incisions are closed, often requiring debridement (removal of non-viable tissue) and skin grafting in the process. [23] The need for fasciotomy may be decreased if mannitol is used, as it can relieve muscle swelling directly. [25] [26]
A compartment space is anatomically determined by an unyielding fascial (and osseous) enclosure of the muscles.The anterior compartment syndrome of the lower leg (often referred to simply as anterior compartment syndrome), can affect any and all four muscles of that compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius.
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The thickness of the fascia can give problems when any inflammation present in the leg has little room to expand into. Blood vessels and nerves can also be affected by the pressure caused by any swelling in the leg. If the pressure becomes great enough, blood flow to the muscle can be blocked, leading to a condition known as compartment ...
Blockages caused by plaque build-up or atherosclerosis in any of these arteries can reduce leg blood circulation, causing leg pain that may interfere with daily life. [4] Standard popliteal bypass surgery involves the bypass of the popliteal artery. [5] During surgery, incisions are made depending on the location of the blockage. [3]