Long-term sequelae of fasciotomy wounds

A retrospective study of patients admitted to an Orthopaedic Trauma Unit ov er an 8-year period requiring fasciotomies, of either upper or lower limb, to reduce the risk of compartment syndrome was performed. Sixty patients we re studied, of which 49 had an underlying fracture. The long-term morbidity of the wounds was studied. Ongoing symptoms such as pain related to the wo und occurred in six patients (10%) and altered sensation within the margins of the wound occurred in 46 patients (77%). Examination revealed 24 patien ts (40%) with dry scaly skin, 20 patients (33%) with pruritus, 18 patients (30%) with discoloured wounds, 15 patients (25%) with swollen limbs, 16 pat ients (26%) with tethered scars, eight patients (13%) with recurrent ulcera tion, eight patients (13%) with muscle herniation and four patients (7%) wi th tethered tendons. The appearance of the scars affected patients such tha t 14 (23%) kept the wound covered, 17 (28%) changed hobbies and seven (12%) changed occupation. This study reveals a significant morbidity associated with fasciotomy wounds. In light of these findings, further consideration s hould be given to techniques that reduce both the symptoms and examination findings mentioned above and the aesthetic insult to the affected limb. (C) 2000 The British Association of Plastic Surgeons.