A fasciotomy involves the surgeon cutting the small fibrous band of tissue wrapped around the suspensory ligament. This band cannot expand with the swelling, causing pressure and pain on the ligament. The medical condition is compartment syndrome. Compartment syndrome occurs when any tissue experiences increased pressure in an enclosed space resulting in a restricted blood supply.
Imagine breaking your ring finger. Your finger swells, but is unable to expand where the ring is located, resulting in a great deal of pressure and pain. This is what is happening to the injured suspensory ligament. When the ring is cut off, like the fibrous band, pressure is relieved.
The neurectomy involves cutting the lateral plantar nerve, relieving pain to the top portion of the suspensory.
Surgery can be an option when other methods of treatment such as stall rest, stem cell therapies, and shockwave are proving ineffective. Fasciotomy combined with neurectomy is estimated to have an 85% success rate for high suspensory injuries.