Surgical decompression remains the only effective treatment for the ischemia of the muscles and nerves of the leg that constitutes the principal defect in the compartment syndromes. Recently, partial fibulectomy has been proposed as a good way to decompress all four compartments instead of the older double incision. Both methods are effective in satisfactorily reducing intracompartmental pressures, as documented by our wick catheter measurements. However, the double-incision technique is easier, faster, and safer, and is the treatment of choice when four-compartment decompressive fasciotomy is indicated.