CPT® Code 24495

Decompression fasciotomy is a surgical procedure aimed at alleviating pressure within muscle compartments, specifically in the forearm, to treat a condition known as compartment syndrome. This syndrome occurs when swelling within a muscle compartment leads to increased pressure, which can compress blood vessels and nerves, potentially resulting in severe complications such as permanent muscle and nerve damage. The muscle compartments in the forearm are encased in a tough layer of connective tissue called fascia, which does not stretch. When swelling occurs, the fascia restricts the expansion of the muscle compartment, leading to compromised blood flow. In the forearm, the brachial artery, which supplies blood to the arm and hand, may also be at risk of damage due to this increased pressure. The forearm contains two primary compartments: the flexor (volar) compartment, which houses muscles that flex the wrist and fingers, and the extensor (dorsal) compartment, which contains muscles responsible for extending the wrist and fingers. The procedure typically begins with decompression of the flexor compartment, followed by exploration of the brachial artery to assess any potential damage. If necessary, the extensor compartment may also be decompressed. The surgical approach involves making incisions through the skin and fascia to relieve pressure, inspect muscle and nerve integrity, and remove any nonviable tissue. The incisions are left open to allow for swelling reduction before final closure, which usually occurs within a few days post-surgery.