In the absence of reliable evidence, it is the opinion of the work group that fasciotomy technique (e.g. one vs two incision, placement of incisions) is less important than achieving complete decompression of the compartments of the affected extremity.

Management of Acute Compartment Syndrome
This guideline was produced in collaboration with METRC, with funding provided by the US Department of Defense. Endorsed by: ACS and AOFAS
Consensus CONSENSUS
Rationale
Four low quality studies (Bible, 2013; Jang, 2017; Kanj, 2013; Heemskerk, 2003) examined various fasciotomy techniques displaying varying results and inconsistent outcomes, which led to the lack of an evidence-based recommendation for this topic.

Clinicians should consider the soft tissue envelope when determining incision placement as the literature does not clearly suggest an advantage or disadvantage for choosing different techniques. Surgeons should choose the fasciotomy technique deemed best to allow for full decompression of the involved compartments and may be tailored to other considerations such as plans for staged fixation. For the inexperienced clinician, it is recommended that the 2-incision method be used.