American Board of Internal Medicine (ABIM) Certification Practice Exam

Fasciotomy may be considered in patients with threatened limbs within what time frame of revascularization?

1. 2 hours

2. 4 hours

3. 6 hours

4. 8 hours

The correct answer is: 4 hours

Fasciotomy is a surgical procedure indicated in cases of acute compartment syndrome, often a result of conditions such as severe fractures, crush injuries, or vascular compromise that can threaten limb viability. The critical time frame for performing a fasciotomy in conjunction with revascularization procedures is essential for ensuring adequate muscle and nerve function in the affected limb. Revascularization can restore blood flow, but if there is a delay in addressing underlying compartment syndrome, the risk of irreversible muscle and nerve damage increases. The general consensus in the medical community and guidelines suggests that fasciotomy should be performed within four to six hours of the onset of symptoms related to compartment syndrome. In cases of revascularization, if there is significant neurological and muscular compromise due to pressure build-up within a compartment, timely fasciotomy can prevent long-term damage. Therefore, the recommendation to consider fasciotomy within a timeframe of four hours makes sense, as it gives enough time to evaluate the patient and address any complications that may arise from ischemia. The preservation of limb function and integrity greatly diminishes when intervention occurs beyond this window, as the likelihood of successful recovery decreases significantly after approximately six hours has elapsed. This approach aims to balance the need for rapid surgical intervention with the benefits