CPT® Code 26037

A decompressive fasciotomy of the hand is a surgical procedure aimed at alleviating pressure within the osteofascial compartments of the hand, which can become critically elevated due to conditions such as compartment syndrome. Compartment syndrome may arise from various causes, including traumatic injuries like crushing incidents, thermal injuries such as burns, or inadvertent infiltration of intravenous medications into the soft tissues of the hand. The hand consists of ten distinct osteofascial compartments, each containing muscles, nerves, and blood vessels, which are encased in a fibrous sheath. When pressure builds up within these compartments, it can lead to severe complications, including muscle and nerve damage. To effectively relieve this pressure, the surgeon may utilize dorsal incisions over the second and fourth metacarpals, allowing access to the affected compartments. The procedure involves retracting the extensor tendons to expose both the dorsal and volar interosseous compartments. Each compartment is then opened through a longitudinal incision, facilitating the release of pressure. Following the fasciotomy, the surgical wounds are typically covered with a sterile dressing to manage any swelling. Once the tissue swelling has subsided, the wounds may be closed with sutures, or if necessary, separate skin grafting procedures may be performed to promote healing and restore the integrity of the hand's structure.