Name of the Procedure:

Fasciotomy, Iliotibial (Tenotomy), Open

Summary

An open fasciotomy of the iliotibial band is a surgical procedure where an incision is made to release tension in the iliotibial band, a thick fascia running along the outside of the thigh from the hip to the knee. This procedure can alleviate pain and improve mobility.

Purpose

This procedure targets chronic tension and pain in the iliotibial band, often encountered in runners and athletes. It aims to reduce pain, inflammation, and prevent further injury by releasing tight fascia.

Indications

• Chronic iliotibial band syndrome (ITBS) unresponsive to conservative treatments
• Pain and inflammation of the lateral knee or thigh
• Difficulty in performing physical activities
• Patients not responding to physical therapy or anti-inflammatory medications

Preparation

• Patients may need to fast for several hours before the surgery.
• Adjustments to medications might be required, especially blood thinners.
• Preoperative assessments might include physical exams and imaging studies like MRI or ultrasound to determine the severity of the condition.

Procedure Description

1. The patient is placed under general or regional anesthesia.
2. The surgical area is sterilized, and an incision is made over the iliotibial band.
3. The surgeon carefully cuts the iliotibial band to release tension.
4. The surrounding structures are inspected for any additional issues.
5. The incision is closed with sutures.
6. Sterile dressings are applied to the wound.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurse
• Scrub technician

Risks and Complications

• Infection at the incision site
• Damage to surrounding nerves or blood vessels
• Excessive bleeding or hematoma
• Scar tissue formation
• Persistent pain or recurrence of symptoms

Benefits

• Relief from chronic pain and inflammation
• Improved mobility and function of the affected leg
• Enhanced ability to perform physical activities
• Reduction in the risk of future injury

Recovery

• The patient may need to use crutches initially.
• Physical therapy is often recommended to regain strength and flexibility.
• Healing generally takes a few weeks, with restrictions on heavy activities and sports for a few months.
• Follow-up appointments are necessary to monitor recovery and progress.

Alternatives

• Physical therapy to stretch and strengthen the iliotibial band
• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain management
• Corticosteroid injections to reduce inflammation
• Use of orthotics or changes in exercise routines to alleviate stress on the band
• Each alternative has its own set of benefits and limitations, typically less invasive but may be less effective for severe cases.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Postoperative pain can be managed with prescribed pain medications. Some discomfort and swelling are normal, and following care instructions will aid in recovery. Physical therapy may follow to ensure the best outcome and swift return to normal activities.