Release surgeries done for Tibia patients (Question for Dr. Assayag)

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Your website says that you do these for your tibia patients:

Peroneal nerve release
Fasciotomy, gastrocnemius open bilateral
Anterior compartment percutaneous fasciotomies

My LL doctor did not do any of them. I did have a fasciotomy for exertional compartment syndrome in my tibialis anterior muscles (more on that below). Now I'm wondering if anything else regarding these three procedures done after the fact would provide any benefit going forward, especially in the long run.

1. Peroneal nerve release: I can do everything in the following video, so I don't think I have drop foot (at least not a severe case) although sometimes working the pedals in my car requires a bit more muscular effort and stretching than I remember needing before. But maybe that's just because the elongated legs are forced into a more awkward angle relative to the pedals. Since getting LL I've had to put the seat of the chair all the way back and the backrest all the way forward in order to be able to drive.



2. Fasciotomy, gastrocnemius open bilateral: From what I've read it appears that this is done to prevent compartment syndrome in the back of the calf. Having experienced confirmed, surgery-warranting exertional compartment syndrome in the tibialis anterior muscles, I'm pretty sure I don't have it in the rear of the leg. Is there any other symptom someone might experience to indicate a potential problem here?

3. Anterior compartment percutaneous fasciotomies: As I was doing my post-frame removal rehabilitation I noticed excessive fatigue in my tibialis anterior muscles casued by just walking. I was diagnosed with exertional compartment syndrome and underwent fasciotomy surgery. There's one scar on each leg, about 2.5 inches long running vertically on the skin covering those muscles. For the previous two procedures, your website mentions specific anatomy to be operated on. I'm wondering if you normally make cuts anywhere else in the anterior of the leg other than the tibialis anterior muscles.

Thank you so much for your contributions to this forum.

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Bump.

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bump

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Quote from: Michael J. Assayag, MD on January 18, 2023, 10:22:50 PMthanks for bumping!Anterior compartment fasciotomy is done to prevent compartment syndrome post op. Very rare, but catastrophic when it happens. Patients hate the aspect it gives their anterior shin in the long run and for that reason, i do not do it often anymore in height lengthening patients.

What are the symptoms of the rare, catastrophic compartment syndrome this is intended to prevent?