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.