On the underside of the foot and heel is a tight band of tissue called the plantar fascia. Sometimes the plantar fascia become inflamed or injured as a result of trauma, infection, or constant strain (long periods on one's feet, being overweight, or wearing shoes that do not support the foot well). This inflammation produces pain in the heel - a condition known as plantar fasciitis (sometimes called a heel spur or stone bruise).
One way to treat plantar fasciitis is through plantar fasciotomy, a surgery to reduce the tension on the plantar fascia. The procedure can be performed openly or endoscopically. Endoscopic fasciotomy (considered minimally invasive) has no large incision, and is usually less painful than open surgery, with faster recovery times (limited weight-bearing can begin immediately). Open procedure has increased risk of infection, calcaneal fracture, and nerve entrapment.
With endoscopic surgery, the surgeon inserts a thin, flexible tube and camera through one or more small incisions in the skin, typically on the side(s) of the heel below the ankle bone. The surgeon can examine and release/remove a portion of the fascia through this tube. The incisions are then closed.
Surgery is generally only performed for severe, chronic plantar fasciitis / heel spur syndrome, where symptoms have continued for at least 6 to 12 months, and after home and other nonsurgical treatments have proven unsuccessful. Both open and endoscopic methods are typically done as same-day procedures under anesthesia. Most patients return to their normal activities in 3 to 6 weeks.