Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Forearm Compartment Release - Fasciotomy

Preoperative Patient Care
Operative Techniques

Preoperative Plan


Execute surgical walkthrough

  • describe key steps of the procedure to the attending verbally prior to the start of the case
  • describe potential complications and the steps to avoid them

Room Preparation


Surgical instrumentation

  • curved mayo scissors


Room setup and equipment

  • standard OR table
  • hand table


Patient positioning

  • patient supine

Ulnar Volar Incision


Mark and make the incision

  • make a straight line incision over the first third of the ulnar aspect of the volar forearm
  • start the incision just proximal to the wrist crease and extend the incision to just distal to the ulnar aspect of the elbow flexion crease


Identify the volar compartment

  • carry the incision down through the fascia into the volar compartment

Deep Dissection


Open the fascia

  • open the fascia along the length of the compartment


Examine the soft tissues

  • examine the deep and the superficial muscles

Radial Incision


Mark and make the second volar incision

  • make a second incision starting with a middorsal straight line incision that begins 3 to 4 cm proximal to the wrist crease


Extend the incision

  • extend the incision down to the radial aspect of the flexion crease

Fascial Release


Release the compartments

  • release the mobile wad and dorsal compartment


Incise the fascia

  • incise the fascia for both compartments over the entire length of the incision
  • examine the muscles in both compartments
  • after release of the fascia, the muscles should bulge out of the incision
  • do not debride any muscle during this procedure
  • some muscles with questionable viability may recover after the fascial release

Wound Management


Pack the wounds

  • pack the wounds with moist dressing until the second look procedure

2nd Look Procedure


Debride necrotic tissue

  • aggressively debride any necrotic tissue with a no. 10 blade in a tangential manner until bleeding tissue is seen


Cover the wounds

  • place moist dressings over large wounds with exposed deep structures of neurovascular structures until coverage can be performed
  • if coverage is not needed, perform moist dressing changes for the next 7 to 14 days once the edema subsides, perform primary closure or skin grafting as needed
Postoperative Patient Care
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options