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Hand Fasciotomy

 C. Hands

                        1. hand has 10 separate fascial compartments
                                    a. 4 dorsal interossei
                                    b. 3 volar interossei
                                    c. thenar muscles
                                    d. hypothenar muscles
                                    e. adductor pollicis                                   
                        2. fasciotomy technique – consists of 4 incisions (see figure 7)
                                    a. one incision on radial side of thumb metacarpal releases thenar compartment (figure 8)
                                    b. dorsal incision over index finger metacarpal used to release first and second dorsal interossei and to reach ulnar-to-index finger metacarpal and to release volar interossei and adductor pollicis
                                    c. dorsal incision over ring finger metacarpal used to release third and fourth dorsal interossei and to reach down along radial aspect of ring finger and small finger metatarsal to release volar interossei
                                    d. incision placed at ulnar aspect of small finger to release hypothenar muscles
                                    e. although compartments not well defined in fingers, grossly edematous fingers may require release of dermal and fascial constriction; care should be taken to place skin incision away from neurovascular bundles