VENOUS INSUFFICIENCY - A LATE SEQUELAE OF 4-COMPARTMENT FASCIOTOMY INTHE LOWER-EXTREMITY

Four-compartment fasciotomies used to relieve abnormally high compartm ent pressures necessitate interruption of the ensheathing fascial memb rane. In the calf, this is considered an important component in mainta ining a viable musculovenous pump and preventing venous hypertension, a leading cause of venous insufficiency. Through postoperative physica l examination and photoplethysmography evaluation of 47 patients who u nderwent this procedure, no indication exists that division of the fas cial component leads to calf pump dysfunction and chronic venous insuf ficiency. Of the patients studied, 92 per cent had unchanged musculove nous pump function upon photoplethysmography reevaluation at 19 weeks compared with the initial values recorded 6 weeks postoperatively; 6 p er cent had improved venous flow, while only one of the 47 (2%) had ve nous recovery measurements consistent with diminished venous flow.