Fasciotomy for severe, blunt and penetrating trauma of the extremity.

Blunt or penetrating injuries to the extremity with vascular or severe soft tissue and skeletal trauma frequently require fasciotomy. Long term follow-up studies of these patients are rare. From 1976 to 1983, 85 patients underwent 39 fasciotomies upon the upper extremities and 57 upon the lower. Amputations were required in 11 patients; four due to primary vascular compromise, six to severe crush injury and one to electric burn with myonecrosis. The fasciotomy was not etiologically related to limb loss in any of these patients. Osteomyelitis occurred in two patients. Long term follow-up data was obtained by telephone and mail survey from 23 of the 61 patients five to 11 years after injury. Pain, weakness and paresthesia were major determinants of long term morbidity. Chronic edema was present in two patients. Seven of the patients interviewed were unemployed due to the injuries they received to the extremities. Most symptoms were believed to be due to the severity of the injury, and none were directly attributed to the fasciotomy. When fasciotomy is indicated, it is a safe adjunctive procedure in limb salvage and contributes very little to the long term morbidity of patients with severe trauma to the extremity.