Fasciotomy
What is Fasciotomy?
Fasciotomy is a surgical procedure to relieve pressure in a muscle compartment by making incisions through the fascia (the connective tissue surrounding muscles), typically to treat acute compartment syndrome—a medical emergency caused by increased pressure within a confined space, leading to compromised blood flow and tissue damage. It can also be used prophylactically in high-risk trauma cases. In India, fasciotomy is performed in trauma centers and orthopedic surgery units, offering high-quality care at affordable costs. For patients and families in India, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.
Why you need Fasciotomy?
Fasciotomy is indicated for:
- Acute compartment syndrome (ACS): Increased pressure in a muscle compartment, often due to:
- Trauma (e.g., fractures, crush injuries), especially in the lower leg, forearm, or thigh.
- Burns, prolonged limb compression (e.g., drug overdose, surgery), or vascular injury.
- Symptoms: Severe pain (out of proportion to injury), paresthesia, pallor, pulselessness, and paralysis (the “5 Ps”).
- Chronic exertional compartment syndrome: Rare, in athletes with repetitive muscle use, though fasciotomy is less urgent.
- Prophylactic fasciotomy: In high-risk cases (e.g., severe trauma with vascular repair, prolonged ischemia).
The procedure aims to decompress the compartment, restore blood flow, prevent muscle/nerve damage, and avoid long-term disability. In India, hospitals like Apollo, Fortis, Medanta, and AIIMS specialize in fasciotomy, often performed by orthopedic or trauma surgeons.
Why Do APR Costs Vary in India?
Costs range from ₹50,000 to ₹3 lakh :
- Procedure Complexity: Single limb fasciotomy (₹50,000–₹1.5 lakh), multiple compartments or additional procedures (₹1.5–3 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹20,000–₹80,000).
- Surgeon’s Expertise: Experienced orthopedic or trauma surgeons charge more.
- Additional Costs: ICU stay, diagnostics (X-ray, CT), skin grafting, prolonged hospitalization.
- Insurance: Covered for emergencies; Ayushman Bharat offers subsidies.
Fasciotomy Procedure
The procedure is tailored to the affected compartment and urgency:
- Before Surgery Evaluation:
- Diagnosis:
- Blood tests assess for rhabdomyolysis (elevated creatine kinase, myoglobin) and kidney function.
- IV fluids and pain management stabilize the patient.
- Diagnosis:
- Surgical Techniques:
- Emergency Fasciotomy:
- Performed under general or regional anesthesia (e.g., spinal), lasting 30–60 minutes per limb.
- The patient is positioned supine or prone, depending on the compartment (e.g., leg, forearm).
- Lower Leg (Most Common):
- Four compartments (anterior, lateral, superficial posterior, deep posterior) are decompressed via two incisions:
- Lateral incision: Over the fibula, releasing anterior and lateral compartments.
- Medial incision: 1–2 cm posterior to the tibia, releasing posterior compartments.
- The fascia is incised longitudinally to relieve pressure, ensuring all compartments are decompressed.
- Four compartments (anterior, lateral, superficial posterior, deep posterior) are decompressed via two incisions:
- Forearm:
- Volar and dorsal incisions release the flexor and extensor compartments.
- Thigh or Hand: Less common, tailored to affected compartments.
- Wound Management:
- The skin is left open to prevent pressure buildup; wounds are covered with sterile dressings or a vacuum-assisted closure (VAC) device.
- Delayed closure or skin grafting is performed 3–7 days later, once swelling subsides and tissues are viable.
- Additional Procedures:
- Fracture stabilization (e.g., external fixation) or vascular repair (e.g., shunting) may be done simultaneously.
- Emergency Fasciotomy:
- After Surgery:
- Patients are monitored in the ward or ICU (if unstable) for 2–5 days.
- Pain is managed with analgesics (e.g., morphine, NSAIDs); antibiotics prevent infection.
- The wound is inspected daily for viability; debridement may be needed for necrotic tissue.
- Delayed closure or skin grafting occurs once swelling resolves.
Recovery After Fasciotomy
- Hospital Stay: 2–7 days, depending on wound closure and complications.
- Post-Surgery Care:
- Pain managed with analgesics; limb elevation reduces swelling.
- Antibiotics (e.g., cefazolin) for 3–5 days prevent infection.
- Physical therapy starts early to prevent stiffness; range-of-motion exercises begin within days.
- Wounds are managed with dressings or VAC; closure or grafting occurs 3–7 days post-fasciotomy.
- Activity/Diet:
- Crutches or non-weight-bearing for 2–4 weeks (lower limb); strenuous activities avoided for 6–12 weeks.
- Normal diet; high-protein intake supports healing.
- Follow-Up:
- Weekly visits for 1–2 months to monitor wound healing and infection.
- Physical therapy for 3–6 months restores strength and function.
Most resume normal activities in 6–12 weeks. Functional recovery is 80–90% with timely fasciotomy (<6 hours from symptom onset); delays increase risk of permanent damage (e.g., muscle necrosis, foot drop).
Risks and Complications
- Surgical Risks: Bleeding, infection (5–10%), nerve injury (e.g., peroneal nerve, 1–3%).
- Wound Issues: Delayed healing, need for skin grafting (20–30%), wound dehiscence.
- General Risks: Anesthesia reactions, blood clots.
- Long-Term: Muscle weakness, chronic pain, Volkmann’s contracture (if delayed), recurrent compartment syndrome (rare).
Report fever, severe pain, or wound redness promptly.
Frequently Asked Questions (FAQs)
What causes compartment syndrome?
Trauma (fractures, crush injuries), burns, prolonged compression, or vascular injury.
Is fasciotomy urgent?
Yes, for acute compartment syndrome; delays >6 hours risk permanent muscle/nerve damage.
Will I have a scar?
Yes, fasciotomy leaves scars; skin grafting may be needed for large wounds.
How soon can I resume activities?
Light activities in 2–4 weeks, normal routines in 6–12 weeks.
Is fasciotomy covered by insurance in India?
Yes, for emergencies; confirm with your provider.
Signs of complications?
Fever, severe pain, wound redness, or loss of sensation.
Will I regain full function?
80–90% recover fully with timely surgery; delays may cause permanent weakness or contractures.
Lifestyle changes post-surgery?
Physical therapy, avoid high-impact activities during recovery, monitor for recurrence.
Conclusion
Fasciotomy is a critical procedure to treat acute compartment syndrome, preventing irreversible damage with timely intervention. India’s top hospitals (Apollo, Fortis, AIIMS) offer affordable, expert care. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach fasciotomy confidently. Consult an orthopedic or trauma surgeon for personalized guidance and successful treatment.
Looking for Best Hospitals for Fasciotomy
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
50,000 |
2,00,000 |
Ahmedabad |
80,000 |
3,00,000 |
Ajmer |
50,000 |
2,00,000 |
Aligarh |
50,000 |
2,00,000 |
Allahabad |
50,000 |
2,00,000 |
Amritsar |
70,000 |
2,50,000 |
Aurangabad |
70,000 |
2,50,000 |
Bangalore |
80,000 |
3,00,000 |
Bareilly |
50,000 |
2,00,000 |
Belgaum |
70,000 |
2,50,000 |
Bhopal |
70,000 |
2,50,000 |
Bhubaneswar |
70,000 |
2,50,000 |
Bikaner |
50,000 |
2,00,000 |
Chandigarh |
80,000 |
3,00,000 |
Chennai |
80,000 |
3,00,000 |
Coimbatore |
80,000 |
3,00,000 |
Dehradun |
70,000 |
2,50,000 |
Delhi |
80,000 |
3,00,000 |
Dhanbad |
50,000 |
2,00,000 |
Durgapur |
50,000 |
2,00,000 |
Faridabad |
80,000 |
3,00,000 |
Ghaziabad |
80,000 |
3,00,000 |
Gorakhpur |
50,000 |
2,00,000 |
Guntur |
70,000 |
2,50,000 |
Gurgaon |
80,000 |
3,00,000 |
Guwahati |
70,000 |
2,50,000 |
Gwalior |
50,000 |
2,00,000 |
Hyderabad |
80,000 |
3,00,000 |
Indore |
80,000 |
3,00,000 |
Jabalpur |
50,000 |
2,00,000 |
Jaipur |
80,000 |
3,00,000 |
Jalandhar |
70,000 |
2,50,000 |
Jamshedpur |
70,000 |
2,50,000 |
Jodhpur |
50,000 |
2,00,000 |
Kanpur |
50,000 |
2,00,000 |
Kochi |
80,000 |
3,00,000 |
Kolkata |
80,000 |
3,00,000 |
Kollam |
70,000 |
2,50,000 |
Lucknow |
70,000 |
2,50,000 |
Ludhiana |
80,000 |
3,00,000 |
Madurai |
70,000 |
2,50,000 |
Mangalore |
70,000 |
2,50,000 |
Meerut |
50,000 |
2,00,000 |
Moradabad |
50,000 |
2,00,000 |
Mumbai |
80,000 |
3,00,000 |
Mysore |
80,000 |
3,00,000 |
Nagpur |
70,000 |
2,50,000 |
Nashik |
70,000 |
2,50,000 |
Navi Mumbai |
80,000 |
3,00,000 |
Noida |
80,000 |
3,00,000 |
Patna |
50,000 |
2,00,000 |
Pune |
80,000 |
3,00,000 |
Raipur |
70,000 |
2,50,000 |
Rajkot |
70,000 |
2,50,000 |
Ranchi |
50,000 |
2,00,000 |
Surat |
80,000 |
3,00,000 |
Thane |
80,000 |
3,00,000 |
Vadodara |
70,000 |
2,50,000 |
Varanasi |
50,000 |
2,00,000 |
Visakhapatnam |
70,000 |
2,50,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.