A plantar fasciotomy is a surgical procedure that may be performed on patients who experience persistent pain due to plantar fasciitis. This is an inflammatory condition that involves the connective tissue, called the fascia, on the bottom of the foot, and it may be painful enough to be disabling. During this surgery, the doctor will remove a small portion of the tissue to reduce the strain. Before undergoing a plantar fasciotomy, patients should talk to their doctors about the potential risks and the expected recovery time.
Not all patients are good candidates for this type of surgery. Patients will be expected to try more conservative treatments for about nine to 12 months, such as using arch supports and resting the foot. If these treatments do not result in sufficient relief of pain, a fasciotomy may be considered.
Prior to the surgery, the patient should disclose his other medical conditions, as well as any medications or supplements he takes. Certain drugs, such as blood thinners, may need to be discontinued for a period of time. The patient will be instructed to refrain from consuming foods and beverages for a brief time before the surgery. It's likely that he will also work with a physical therapist to learn how to use crutches.
Those who are anxious about the plantar fasciotomy may receive a sedative. This surgery is usually performed with a local anesthetic to numb the area, but the patient is awake throughout it. After making two small incisions on the heel of the affected foot, the surgeon will insert a tiny camera to ensure accuracy. He will cut part of the fascia and remove a small amount of it. Over time, the connective tissue will regrow in the space, which lengthens the fascia.
The entire plantar fasciotomy takes approximately one hour to complete. Patients should have someone else drive them home from the hospital. They should expect to rest at home for several days, and they will likely need to cover the foot with a special shoe. The doctor will instruct the patient to keep the foot elevated as much as possible, and to apply ice for about 10 minutes several times daily.
Following a successful plantar fasciotomy, the patient should work with a physical therapist. Certain stretches and exercises can help heal the foot and prevent recurring problems. The patient should also be encouraged to wear shoes with arch supports.
Certain complications may occur with a plantar fasciotomy, such as an infection, bleeding, or an adverse reaction to the anesthesia. It is also possible that the arch will flatten or the fascia will rupture. Some patients may also experience recurring pain in the heel, despite the surgery. Following a plantar fasciotomy, the patient should contact his doctor immediately if he notices persistent bleeding, persistent pain, or a fever.