Rockwood, Green, and Wilkins' Fractures, 10e Package

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SECTION ONE • Fundamentals of Pediatric Fracture Care

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A - Anterior compartment B - Lateral compartment C - T posterior D - Posterior compartment E - Superficial posterior compartment

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Figure 6-10. Decompressive fasciotomy of the lower leg. A: Two-incision approach. The anterolateral inci sion allows decompression of the anterior and lateral compartments. The medial incision allows decom pression of the superficial posterior and the deep posterior compartments. The arrows are indicating the compartments that are released with each incision. B: One-incision approach. A single lateral incision allows decompression of all four compartments in the lower leg. (Courtesy of Paul Choi, MD.)

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Figure 6-11. Decompressive fasciotomy of the foot. Through a dorsal approach, two longitudinal skin inci sions over the second and fourth metatarsals can be utilized to decompress all nine compartments of the foot. The superficial fascia is divided over each interspace to decompress the interosseous ( I ) compartments (×4). (Caution: Interosseous veins and the distal dorsalis pedis arterial branches are in the first interspace.) Next, the adductor, central (superficial and deep), medial, and lateral compartments are decompressed through each interspace. Many authors, however, recommend a third medial incision to decompress the medial/calcaneal compartment.