The significance of the three volar spaces in forearm compartment syndrome: a clinical and cadaveric correlation.

Abstract

The goal of this study was to assess the importance of the 3 volar spaces in forearm compartment syndrome in a prospective manner. A cadaveric model was developed to correlate with our clinical experience. All but 1 of 21 volar compartments (superficial volar, deep volar, and pronator quadratus spaces) in 7 patients in our clinical series decompressed adequately after release of the superficial volar fascia. One patient needed further release of the pronator quadratus compartment; he had suffered a combined crush and vascular injury. All volar compartments in our cadaveric model decompressed with superficial fasciotomy. Prefasciotomy and postfasciotomy pressures should be obtained from all 3 compartments of the volar forearm. Superficial fasciotomy usually adequately decompresses the entire volar forearm; however, in the event that deep compartment pressures remain high after superficial fasciotomy, release of the affected space is indicated.