What is Endoscopic Plantar Fasciotomy
Endoscopic plantar fasciotomy is a procedure to cut or release a band of thick tissue on the bottom of your foot (plantar fascia). The plantar fascia connects your heel bone to the base of your toes. You can have heel pain if the fascia swells or becomes irritated (plantar fasciitis).
You may need this procedure if you have heel pain from plantar fasciitis and other treatments have not helped. This procedure involves placing a thin, lighted device (endoscope) through a small incision in your skin. The surgeon can see the fascia and perform the procedure through this device.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Infection.
- Bleeding.
- Allergic reactions to medicines.
- Damage to other structures or organs.
- Short-term loss of feeling (numbness) at the site of the incision.
- A pooling of blood (hematoma) in the wound.
- Scarring.
- Weakness in your foot.
- A return of symptoms.
What happens before the procedure?
- Ask
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
- Follow instructions from your health care provider about eating or drinking restrictions.
- Plan to have someone take you home after the procedure.
- Ask your health care provider how your surgical site will be marked or identified.
- You may be given antibiotic medicine to help prevent infection.
What happens during the procedure?
- To
reduce your risk of infection:
- Your health care team will wash or sanitize their hands.
- Your skin will be washed with soap.
- An IV tube will be inserted into one of your veins.
- You
will be given one or more of the following:
- A medicine to help you relax (sedative).
- A medicine to numb the area (local anesthetic).
- A medicine to make you fall asleep (general anesthetic).
- A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
- A small incision will be made on one side or both sides of your heel. The endoscope will be inserted through the incision. The endoscope will allow the surgeon to see the inside of your foot on a video screen. This will give the surgeon a good view of the plantar fascia.
- Tools will be inserted through the endoscope to cut the layers of fascia.
- The endoscope will be removed, and the incision will be closed with stitches (sutures).
- A bandage (dressing) will be placed over the bottom of your foot.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
- You will be given pain medicine as needed.
- You may be given a boot or protective shoe to wear while your foot heals. You may also be given crutches to keep weight off of your foot.
- Do notdrive for 24 hours if you received a sedative.
Endoscopic Plantar Fasciotomy, Care After
Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.
What can I expect after the procedure?
After the procedure, it is common to have:
- Foot pain and stiffness.
- Swelling in the incision area.
Follow these instructions at home:
If you have a boot or protective shoe:
- Wear it as told by your health care provider. Remove it only as told by your health care provider.
Incision care
- Follow
instructions from your health care provider about how to take care of your
incision. Make sure you:
- Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
- Change your dressing as told by your health care provider.
- Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
- Check
your incision area every day for signs of infection. Check for:
- More redness, swelling, or pain.
- More fluid or blood.
- Warmth.
- Pus or a bad smell.
Bathing
- Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
- If your health care provider approves bathing and showering, cover the dressing with a watertight plastic bag to protect it from water. Do notlet the dressing get wet.
- Keep the dressing dry until your health care provider says it can be removed.
Managing pain, stiffness, and swelling
- If
directed, apply ice to the affected area.
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times a day.
- Move your toes often to avoid stiffness and to lessen swelling.
- Raise (elevate) the affected area above the level of your heart while you are sitting or lying down.
Driving
- Do notdrive for 24 hours if you received a sedative.
- Do notdrive or operate heavy machinery while taking prescription pain medicine.
- Ask your health care provider when it is safe to drive if you have been given a boot or shoe to wear on a foot that you use for driving.
Activity
- If you have crutches, use them to keep weight off your foot as told by your health care provider.
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
General instructions
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have more redness, swelling, or pain at the site of your incision.
- You have more fluid or blood coming from your incision.
- Your incision feels warm to the touch.
- You have pus or a bad smell coming from your incision.
- You have a loss of feeling (numbness) in your foot.
- You have difficulty moving your foot.
- You have a fever.
Get help right away if:
- You have swelling in your leg or calf.
