Two-Incision Four-Compartment Lower Extremity Fasciotomy

  • Carolyn Gosztyla
  • Eric Jelin


This chapter describes the surgical procedure for two-incision four-compartment lower extremity fasciotomy. The text includes an introduction that outlines the indications, risks, alternatives, essential steps, needed equipment, and variations in technique. This introduction is followed by a template operative dictation. A description of the following critical concepts for this procedure: identifying landmarks for planning surgical incisions, lateral skin incision from upper leg to the ankle, identification of the intramuscular septum, H-type longitudinal incision in the fascia of the anterior and lateral compartments, medial skin incision from the upper leg to the ankle, incision of superficial fascia, longitudinal incision of the soleus muscle until the posterior fascia can be identified, and fascial release of the deep compartment.


Pediatric surgery four-compartment fasciotomy lower extremity trauma compartment syndrome compartment hypertension lower extremity revascularization 

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Carolyn Gosztyla
    • 1
  • Eric Jelin
    • 2
  1. 1.Walter Reed National Military Medical Center, Department of General SurgeryBethesdaUSA
  2. 2.Johns Hopkins, Department of SurgeryBloomberg Children’s CenterBaltimoreUSA

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