Experimental decompression of the fascial compartments of the foot--the basis for fasciotomy in acute compartment syndromes.

Surgical decompression of the foot by fasciotomy is the only effective means of preventing the late consequences of a compartment syndrome i.e., myoneural ischemia. In this study, a slit catheter system was used to monitor the compartment pressures in experimentally induced compartment syndromes of the foot. The ease and rate of decompressing the intracompartmental pressures via a double incision dorsal approach versus a medial longitudinal approach were compared in 40 paired fresh cadaver specimens. In both methods, intracompartmental pressure is satisfactorily decompressed. However, it takes longer after effective fasciotomies for pressures to normalize via the dorsal approach (11 min versus 1 min; P less than 0.01). The double incision dorsal approach is easier to perform and may be the method of choice for fasciotomy associated with fractures of the forefoot requiring internal fixation.