Over the last two years the 29-year-old was beset by ulcerative colitis, a chronic bowel condition, and following surgery the midfielder spent a lengthy period recuperating before returning to training.
Having gradually returned to fitness, including some outings for United’s Under-21 side, the midfielder made his first appearance for the senior side since Boxing Day 2012 as a substitute in the 3-0 win over Aston Villa on Sunday.
Fletcher’s every touch during his 20-minute cameo was cheered by United’s travelling contingent of supporters at Villa Park, but afterwards the Scot reflected on just how close he came to never stepping out onto the pitch again.
“If the operation was not a success there was no way I would be able to play football,” he said.
“My everyday life would be very difficult if it wasn't a success. It was two or three operations not just one, so it was psychologically challenging dealing with surgery as well. But I couldn't live my life at all. I needed something to be done.
“There was a day in about May when we said 'this is it'. Once I came out of that operation it was going to be, 'this has either worked or it hasn't'. It was a very emotional day.
"There was a lot of fear and anxiety and a lot of build-up. But I was in the hands of an unbelievable surgeon, and I put all my trust in him. He was confident, as long as I did everything right. He was confident all the tests were right. When that moment came, it was such a relief.”
The relief at his first-team comeback was even more evident when Fletcher discussed how much the illness affected his everyday life.