A Single-Incision Fasciotomy for Compartment Syndrome of the Lower Leg.

Lower leg fasciotomy may be performed with a single lateral incision with or without fibulectomy, or by a double incision technique, with most surgeons preferring the later. The aim of this article is to describe a variation of an existing single-incision technique that will allow for the release of all four compartments with 1 incision. Our approach uses a paratibial route to release the deep posterior compartment (DPC) rather than a transfibular or parafibular route that has already been discussed in the literature. We approach the DPC from the anterior compartment, whereas the parafibular approach uses the posterior aspect of the fibula to reach the DPC. This affords a faster fasciotomy with a smaller flap, avoids potential damage to neurovascular bundle and among other advantages, makes its especially pragmatic for bedside fasciotomy, without the risk of injury to the peroneal nerves, which is common with dissection at the posterior aspect of the fibula.