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What is a Fasciectomy?
A fasciectomy is a surgical procedure where fascia, connective tissue found throughout the body, is removed to treat or prevent disease. Fascia can be found in close association with muscles, tendons, and other structures. Most commonly, fasciectomies are performed to treat contractures, conditions where muscles remain in a state of tension and cause physical pain, as well as making it difficult for people to perform tasks. This procedure can be performed by orthopedic and general surgeons, as well as specialists like hand surgeons or foot and ankle surgeons.
One common reason to do a fasciectomy is in the case of Dupuytren's contracture, a condition involving the hand and sometimes the foot. In this condition, the muscles and tendons that control the fingers contract, pulling the fingers into a claw-like position. The fingers are frozen in place and cannot be moved, causing pain and discomfort for the patient, as well as interfering with activities. While there are nonsurgical treatments, a fasciectomy can be a very effective treatment, especially when paired with surgical therapy afterward.
Fasciectomy procedures may be performed to treat diseased or injured fascia as well. If patients have deep infections or have experienced physical trauma, it may be necessary to remove some fascia during surgical debridement, where damaged and diseased tissue is excised to promote wound healing. While the surgeon wants to avoid compromising the patient's musculoskeletal system, sometimes fasciectomy may be the only option.
This treatment can be used for contractures in other regions of the body, including contractures associated with scarring, infections, and other medical issues. Before a fasciectomy is performed, the patient will be given a thorough physical evaluation and medical imaging studies may be used to learn more about what is happening inside the body. This information will be used during surgery to allow the surgeon to target the location of the problem.
If a fasciectomy is recommended, the patient can discuss other options with the surgeon, as well as collecting information about the intended surgical outcome, recovery time, and risks. It is advisable to get as much information as possible about a proposed treatment or procedure to assist with making an informed choice. Surgeons are usually happy to answer questions from patients and to refer patients to sources of additional information. Patients will also have an opportunity to meet with anesthesiologists or anesthesia technicians to discuss anesthesia and pain management in preparation for the surgery.
Discussion Comments
@ddljohn-- I think it can depend on how successful the surgery and healing is. We have a lot of post-fasciectomy patients come in for physical therapy where I work. For the most part, regular movement and light exercise can be done very easily and comfortably after the surgery. Very rarely, some people have complications like chronic pain even after surgery.
We do ask people who've had fasciectomy to take it easy with exercise and not go overboard if they feel strain or pain. We also advise using bandages and other supportive equipment to prevent any injuries after the surgery.
And as far as I know, if the patient is unable to go back to regular movement even after physical therapy, they can have another surgery for the fascia to be stitched back.
@turquoise-- My aunt is due to have a fasciectomy next month. She has a contracting fascia in her right leg that is giving her a lot of trouble. She has pain constantly and her doctor has tried various things already- muscle relaxers, pain relievers and physical therapy. It looks like surgery is the only option now.
I'm a little curious, when the connective tissue is cut in a limb, doesn't it make it difficult to use that limb? How is the leg able to take the weight and pressure of the body? It must be more difficult right?
Is your friend able to exercise or play sports after the fasciectomy?
I'm just wondering if my aunt will be able to walk and move around as she was able to before after the surgery.
My friend had to get a fasciectomy not because of contracture but because of a broken bone. They had to do a fasciectomy because the swelling from the broken bone could not be controlled and it threatened a loss of blood circulation to the limb. He could have lost his leg if he didn't have the procedure done, so it literally saved his leg.
It was not easy though, he said it was pretty painful after surgery and took several months to completely heal. He also had a very large scar from it, but that might be specific to his situation.
All fasciectomies don't scar so badly do they?
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