Forearm compartment pressures: An in vitro analysis of open and endoscopicassisted fasciotomy

Pressure reduction for standard open fasciotomy and a novel endoscopic fasc ial release were compared in experimental conditions of elevated forearm co mpartment pressures by continuously monitoring intracompartmental pressures in 22 cadaver forearms. Both methods were effective in diminishing tissue pressures. Intracompartmental pressures were reduced to significantly lower levels following open versus endoscopic assisted fasciotomy (2.9 mm Hg vs 13.2 mm Hg). In the endoscopic group a statistically significant second dec rease in pressure was observed after dermatomy, reducing intracompartmental tissue pressures from 13.2 mm Hg to 3.1 mm Hg. The results of this study s uggest that endoscopic assisted fasciotomy can reduce elevated tissue press ures, confirming previous findings that fascial release is of primary impor tance in decreasing intracompartmental tissue pressures. Open fasciotomy, h owever, gave significantly greater decompression than the endoscopic techni que, a difference that may be even more substantial in the clinical setting due to several limiting factors of this in vitro model. Our results also s uggest that immediate skin closure following fasciotomy increased tissue pr essure and therefore should be avoided. (J Hand Surg 1999;23A:1289-1297. Co pyright (C) 1999 by the American Society for Surgery of the Hand.).