Orthopedic Surgeon Pioneers Bedside Fasciotomy Procedure

Dr Nabil Ebraheim

The chief of orthopedic trauma and the chairman of the Department of Orthopedic Surgery at the University of Toledo Medical School, Professor Nabil Ebraheim, MD, has pioneered multiple surgical techniques, including bedside fasciotomy. Nabil Ebraheim, MD, and the coauthors of a largely cited and used technique bedside fasciotomy study were the first to put into literature discussion of the bedside fasciotomy referencing a large number of cases.

Fasciotomy is a type of surgery performed on patients who have acute compartment syndrome, a painful condition that involves pressure building in the muscles. This procedure usually takes place in an operating room using general anesthesia. Bedside fasciotomy, however, takes place at the bedside under local anesthesia.

It is a quicker way to address the condition if for some reason there is a delay in conducting the procedure in the operating room. Some reasons for delay may include a lack of availability of the operating room, short staff, or reluctance on the part of the patient. If acute compartment syndrome is not handled as soon as possible, permanent muscle damage can occur. The bedside procedure allows for the issue to be addressed as quickly as possible.

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Compartment Syndrome in the Limbs

Nabil Ebraheim pic
Nabil Ebraheim
Image: uthealth.utoledo.edu

Dr. Nabil Ebraheim chairs the department of orthopedic surgery at the University of Toledo Medical Center, where he also serves as the chief of orthopedic trauma and directs the orthopedic trauma fellowship. Possessing an in-depth knowledge of chronic and acute orthopedic conditions, Dr. Nabil Ebraheim is currently authoring a book that addresses compartment syndrome.

Compartment syndrome occurs as a result of excess pressure in a confined space within the body. It is common in the groups of muscles, blood vessels, and nerves in the extremities, where a strong membrane known as the fascia keeps these structures contained. If bleeding or swelling develops within one of these compartments, it inhibits proper blood flow and threatens permanent damage to both muscle and nerve cells.

Most cases of compartment syndrome are acute, meaning that they develop as a result of a broken bone or other injury. The condition may also arise due to the use of anabolic steroids or to inhibited blood flow caused by a tight cast or bandage. Compressed limbs in unconscious patients may lead to acute compression syndrome as well, as may blood clots or the sudden surgical reopening of a blocked blood vessel.

Fewer cases of compartment syndrome are chronic, in that they result from excessive repetitive motions. This most often occurs in athletes and is thus also known as exertional compartment syndrome. Unlike acute compartment syndrome, which can result in muscle tissue death if untreated, exertional compartment syndrome most often resolves on its own if the patient stops the aggravating movement.