Fasciotomy is a surgical procedure that cuts away the fascia to relieve tension or pressure.
Fascia is thin connective tissue covering, or separating, the muscles and internal organs of the body. It varies in thickness, density, elasticity, and composition, and is different from ligaments and tendons.
The fascia can be injured either through constant strain or through trauma. Fasciitis is an inflammation of the fascia. The most common condition for which fasciotomy is performed is plantar fasciitis, an inflammation of the fascia on the bottom of the foot that is sometimes called a heel spur or stone bruise.
Plantar fasciitis is caused by long periods on one's feet, being overweight, or wearing shoes that do not support the foot well. Teachers, mail carriers, runners, and others who make heavy use of their feet are especially likely to suffer from plantar fasciitis.
Plantar fasciitis results in moderate to disabling heel pain. If nine to 12 months of conservative treatment (reducing time on feet, nonsteroid anti-inflammatory drugs, arch supports) under the supervision of a doctor does not result in pain relief, a fasciotomy may be performed. Fasciotomy removes a small portion of the fascia to relieve tension and pain. Connective tissue grows back into the space left by the incision, effectively lengthening the fascia.
When a fasciotomy is performed on other parts of the body, the usual goal is to relieve pressure from a compression injury to a limb. This type of injury often occurs during contact sports or after a snake bite. Blood vessels of the limb are damaged. They swell and leak, causing inflammation. Fluid builds up in the area contained by the fascia. A fasciotomy is performed to relieve this pressure and prevent tissue death. Similar injury occurs in high-voltage electrical burns that cause deep tissue damage.
L. Fleming Fallon Jr., MD, DrPH, The Gale Group Inc., Gale, Detroit,