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Chapter 44 - Lower Extremity Fasciotomies

from Section 9 - Lower Extremities

Published online by Cambridge University Press:  21 October 2019

Demetrios Demetriades
Affiliation:
University of Southern California
Kenji Inaba
Affiliation:
University of Southern California
George Velmahos
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • The lower extremity fascial compartments include three gluteal, three thigh, four calf, and nine of the foot. These compartments contain muscles, nerves, and blood vessels.

  • The compartments of the buttock include the gluteus maximus, the gluteus medius/minimus, and the extension of the fascia lata of the thigh into the gluteal region. The sciatic nerve is the only major neurovascular structure in the compartments of the buttock.

  • The thigh has three compartments:

    • The anterior compartment contains the quadriceps femoris and sartorius muscles, as well as the femoral vessels and femoral nerve.

    • The posterior compartment contains the biceps femoris, semitendinosus, and semimembranosus muscles and the sciatic nerve.

    • The medial compartment contains the adductor muscle group and the gracilis muscle.

  • The lower leg has four leg compartments:

    • The anterior compartment: Contains the tibialis anterior muscle, extensor halluces muscle, extensor digitorum longus muscle, the anterior tibial artery, and the deep peroneal nerve.

    • The lateral compartment: Contains the peroneus longus and brevis muscles, and the superficial peroneal nerve.

    • The superficial posterior compartment: Contains the gastrocnemius muscle, soleus muscles, plantaris muscle, and the sural nerve.

    • The deep posterior compartment: Contains the flexor hallucis longus muscle, flexor digitorum longus muscle, tibialis posterior muscles, popliteus muscle, the posterior tibial artery, and the tibial nerve.

  • The foot contains a total of nine compartments, including four interosseous (medial, lateral, deep, and superficial central) and the adductor hallucis compartments that may require decompression in crush injuries to the foot. The medial, lateral, and superficial compartments pass through the entire length of the foot, while the interosseous compartments and the calcaneal compartments are confined to the forefoot and the hind foot, respectively.

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Publisher: Cambridge University Press
Print publication year: 2020

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