Percutaneous mini open fasciotomy for impending acute compartment syndrome of leg: A study of 25 patients

Background: Compartment syndrome can complicate any fracture and is a challenge for orthopedic surgeons. It is an emergency condition which can lead to profound functional disability, ischemia and gangrene of limb if not promptly diagnosed and treated early. The fasciotomy procedure used widely for compartment syndrome of leg fracture is an open fasciotomy. Delay in fasciotomy wound healing, infection, need of secondary procedures may delay definite fracture fixations. Materials and Methods: We performed a prospective study of post traumatic tibia fractures with impending compartment syndrome treated by mini open percutaneous compartment fasciotomy. Results in terms of arrest of progression of the condition, wound complications, need for secondary procedure for wound healing and cosmetic appearance were evaluated Twenty five patients who were operated between 2010 and 2015 were selected for the study. 25 patients with fracture leg with impending compartment syndrome were treated with mini-open fasciotomy. Patients were reviewed post surgically and data was collected regarding symptoms and outcome assessment using specific parameters. Results: In all of our patients we were able to relieve the compartment pressure by this mini-open approach with pain relief in all (n=25) the patients within 6 hours. Mean healing time of the wound was 7 days and there was no wound infection. Percutaneous mini-open fasciotomy can arrest the progression of compartment syndrome. Need for secondary wound procedure like flap cover, skin grafting, vacuum assisted closure is not required. Definitive management of fracture can be done early with less hospital stay with good cosmetic results. Conclusion: Percutaneous mini-open fasciotomy can be used as a definitive procedure for impending compartment syndrome of leg with minimum surgical complications.