Colleagues,
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I regularly dip in to Podiatry Areana and wanted to find out if we have a recognised treatment pathway for rupture of the plantar fascia. PF has numerous clinical guidelines linked to it and they all suggest the negative mechanical effects of Fasciotomy surgery. When this is unavoidable in the case of traumatic PF rupture, what would be recommend for treatment.
I had a patient present recently with traumatic pain at the insertion with severe discomfort along the course of the structure distally (with and without tension, but worse with tension). The give away factor was the acute swelling and bruising plantarly and in the area of the spring ligament. Interestingly the patient has cavoid feet and doesn't fit the pes planus plastic deformation model.
R.I.C.E was initiated and some low dye strapping for a few days. As the area was vary painful a soft orthosis was used with increased arch support. The patient has been unwilling to rest the foot so I have been unable to immobilise the structure. He is now 8 weeks post injury and applying mechanical theory, the next move would be to try a rigid orthosis.
I would welcome your thoughts on a standard treatment protocol and recommendations for future management of my patient.
Thanks
Neville
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Heel walking more effiicent that forefoot walking
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Functions and Dysfunctions of the Plantar Fascia
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Heel walking more effiicent that forefoot walking
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Functions and Dysfunctions of the Plantar Fascia
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