2nd request need help????
Operative report as follow:
Dx: Bilateral exercise induced compartment syndrome of the lower legs (anterolateral compartment)
Procedure: Release of the anterior and lateral compartments of the lower legs bilaterally.
The patient was taken to the operating room and placed on the table in the supine position. All the bony prominences were well padded. The patient was anesthetized and a laryngeal mask airway was inserted by the department of anesthesia. A pneumatic tourniquet was applied to the upper thighs as well as both legs. They were both set to 350 mmHg, but neither one was inflate. Both lower extremities were then prepped and draped in the usual sterile fashion. 1g of Ancef was delivered intravenously. After 5 minutes of elevation for exsanguinations, the right pneumatic tourniquet was inflated.
A sharp #15 scalpel blade was the used to create a longitudinal incision 2cm anterior to the anterior border of the fibula at the junction of the proximal two â€“ thirds and distal one â€“ third of the lower leg. Deep resection was continued through the subcutaneous fat. Superficial branch of the peroneal nerve was identified. It was then freed from its fascial attachments and traced proximally until it penetrated the fascia to lie on the peroneus muscle. Once the nerve was identified, it was retracted from harms way and initially the anterior compartment was released proximal, then distal, then lateral compartment was released proximal and then distal. Care was taken when releasing the lateral compartment to stay closely to the nerve. Release of the anterior compartment was performed anterior to the nerve. The release was full in both compartments.
The wound was copiously irrigated with sterile saline. Inverted interrupted 2-0 vicryl stitch was used the same procedure was done on the left side.
Ivonne Atanacio CPC, CPC- I, CBCS