Plantar fascia rupture

NewsBot · Sep 9, 2010

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Incidence of Plantar Fascia Ruptures Following Corticosteroid Injection.
Kim C, Cashdollar MR, Mendicino RW, Catanzariti AR, Fuge L.
Foot Ankle Spec. 2010 Sep 3. [Epub ahead of print]

Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m(2). The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.
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NewsBot · Nov 26, 2013

Risk Factors Affecting Chronic Rupture of the Plantar Fascia
Ho Seong Lee, et al
Foot & Ankle International November 25, 2013 1071100713514564

Background: Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis.
Methods: We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups.
Results: Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33.
Conclusion: Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture.
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NewsBot · Mar 28, 2017

The Clinical Features of Plantar Fascia Rupture
Ho Seong Lee, Jong Yoon Lee, and Jae Jung Jeong
J Korean Foot Ankle Soc. 2017 Mar;21(1):17-20. Korean.

Purpose
The purpose of this study is to analyze the clinical features of plantar fascia rupture.

Materials and Methods
We retrospectively reviewed 312 patients with plantar fasciitis between March 2008 and February 2013. We investigated age, sex, site, visual analogue scale (VAS), body mass index (BMI), characteristics of pain, awareness of rupture, and duration of symptoms. Acute rupture was defined as a rupture that occurred during exercise; chronic rupture was defined as a degenerative rupture after plantar fasciitis. We investigated the frequency of acute and chronic rupture.

Results
Among 312 patients, 38 patients (12.2%) were diagnosed with plantar fascia rupture. Thirty-eight patients consisted of 14 men (36.8%) and 24 women (63.2%). The mean age of plantar fascia rupture was 58.29±12.54 years. The mean VAS score was 5.92 points (3~9 points). The mean BMI was 25.92±1.59 kg/m2. Among the 38 patients, 2 patients had acute plantar fascia rupture and 36 had chronic plantar fascia rupture. In 34 patients—out of 36 chronic plantar fascia rupture, there were no subjective symptoms.

Conclusion
Chronic rupture of the plantar fascia that occurred after plantar fasciitis was more common than acute rupture. Chronic rupture occurred at approximately 12% of patients treated with plantar fasciitis. In chronic rupture of the plantar fascia, there were no subjective symptoms of rupture. Therefore, we should doubt chronic rupture of plantar fascia when plantar fasciitis is prolonged.
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NewsBot · Oct 7, 2017

Spontaneous distal rupture of the plantar fascia.
Gitto S, Draghi F
J Clin Ultrasound. 2017 Oct 5. doi: 10.1002/jcu.22531

Spontaneous ruptures of the plantar fascia are uncommon injuries. They typically occur at its calcaneal insertion and usually represent a complication of plantar fasciitis and local treatment with steroid injections. In contrast, distal ruptures commonly result from traumatic injuries. We describe the case of a spontaneous distal rupture of the plantar fascia in a 48-year-old woman with a low level of physical activity and no history of direct injury to the foot, plantar fasciitis, or steroid injections.
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NewsBot · May 14, 2019

Rupture of plantar fascia: Current standard of therapy: A systematic literature review
FlorianDebus et al
Foot and Ankle Surgery; 14 May 2019

Highlights
•In many cases, young and athletic persons are affected by a rupture of the plantar fascia.
•The treatment of rupture of the plantar fascia is a conservative domain.
•The average duration of immobilization was 2.6 weeks in a rigid walker.
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Background
The aim of the present systematic literature review is to give an overview of ruptures of the plantar fascia. For this purpose, a detailed description of the patient collective is provided. However, the focus of this analysis is based on the current therapy concepts. Based on the results the authors propose a standardized therapy concept.

Material and Methods
A systematic literature review was performed using the PubMed database using the terms: ("rupture plantar fascia" OR "plantar fascia tear" OR "rupture plantar aponeurosis"). All articles published in the PubMed database until 07.11.2018 were included. The articles were evaluated with regard to three research question: 1) Which patients are affected by a rupture of the plantar fascia? 2) Which therapy concept was used to treat rupture of the plantar fascia? and 3) Which result was achieved and how was this measured?

Results
A total of 78 studies were identified, of which the full text of 17 were analysed. 12 publications were cases reports, 5 studies were retrospective analyses. Data from 124 patients could be included. The average age of patients was 39.6 years. In 63.2% (n = 12) of the studies, patients with a high level of athletic activity or even professional athletes were analyzed. 94.4% of all patients were treated conservatively. The average duration of immobilization in a rigid walker was 2.6 weeks. In the majority of cases, pain-adapted weight-bearing was allowed in the rigid walker.

Conclusion
There are few available studies concerning the rupture of plantar fascia. The quality of data is poor. The maximum duration of immobilization of 3 weeks in a rigid walker with pain-adapted weight-bearing appears to be the most applied therapy concept. Further studies are needed to evaluate the efficacy of the therapy and to optimize the therapy concept.
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NewsBot · Dec 29, 2019

Ultrasound follow-up of spontaneous tears of the plantar fascia treated with conservative therapies: Two case reports.
Cocco G et al
Medicine (Baltimore). 2019 Dec ;98(52)

RATIONALE:
The plantar fascia (PF) is an important anatomical structure that stabilizes the longitudinal arch of the foot. While plantar fasciitis is a common pathology affecting the foot, tears of the PF are uncommon injuries characterized by acute pain in the plantar aspect of the foot. The main purpose of this paper was to describe, in detail, how the ultrasonographic pattern of PF rupture can be combined with the clinical features to define the prognosis and promptly plan the therapeutic approach.

PATIENT CONCERNS:
In the first case, a 39-year-old male patient was seen due to acute pain in the mid plantar foot which appeared 3 days after a tennis match. The pain was accompanied by a "snap" noise and intense pain. In the second case, a 44-year-old male patient was seen due to pain in the heel region which appeared 2 days after a running session.

DIAGNOSIS:
One case of noninsertional complete tear of the central bundle of the PF with retraction of the 2 stumps and 1 case of partial tear of the central bundle of the PF at the level of the insertional region.

INTERVENTIONS:
Both patients were treated with conservative therapies including load management, oral nonsteroidal anti-inflammatory drugs, foot orthosis, and restriction of sport activities.

OUTCOMES:
At follow-up, the patient with spontaneous complete tear of the PF (noninsertional area) showed a small fibrous bridge between the 2 stumps, with partial alignment of the proximal and distal portions, the ability to walk for a medium to long-distance, and difficulty going up and downstairs. The patient with the spontaneous partial tear (insertional area) showed complete fibrous scar tissue with restoration of the fascial continuity, and the ability to walk for a long-distance and go up and downstairs without pain.

LESSONS:
Based on the clinical and ultrasonographic findings, we suggest that partial tear of the PF in the insertional region presents a favorable prognosis with complete recovery, both clinically and anatomically, while a complete tear in the noninsertional region is associated with partial functional and histological recovery when managed with a conservative approach. Therefore, coupling the clinical findings with the sonohistologic pattern is a valuable approach to plan the most suitable treatment for patients with spontaneous PF tear.
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Dr Rich Blake · Dec 30, 2019

NewsBot said: ↑

Incidence of Plantar Fascia Ruptures Following Corticosteroid Injection.
Kim C, Cashdollar MR, Mendicino RW, Catanzariti AR, Fuge L.
Foot Ankle Spec. 2010 Sep 3. [Epub ahead of print]
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I am glad of the results but we should try many other treatments before we resort to long acting cortisone in the heel of the foot. Rich

NewsBot · Dec 31, 2019

Surgical Repair of Complete Plantar Fascia Ruptures in High-Demand Power Athletes: An Alternative Treatment Option
Susanne OlesenSchaarup et al
The Journal of Foot and Ankle Surgery Volume 59, Issue 1, January–February 2020, Pages 195-200

Surgical repair of complete plantar fascia ruptures has not yet been reported in the literature. Operative technique and outcome are described in 2 gymnasts with heavy plyometric demands who received surgical repair compared with 3 athletes treated nonoperatively. Biomechanics and clinical implications are discussed. In the last 8 years, we have seen 5 high-demand athletes with total rupture of the plantar fascia. This is a retrospective clinical evaluation 1.5 to 8 years postinjury of all 5 patients using dynamic ultrasound, Foot Function Index, sports-specific questions, Foot Posture Index, and foot length. The operated gymnasts returned to the same level of performance within 12 months. None of the conservatively treated athletes returned to preinjury plyometric sports levels but reached a foot load capacity of distance running with the injured foot as limiting factor. Ultrasound with simultaneous dorsiflexion of the toes showed a normal fascia in the operated patients, but a slack fascia that tightened up only at terminal toe dorsiflexion in the conservatively treated group. According to the Foot Function Index, the operated patients reported no complaints, whereas the nonoperative group had clinical relevant impairments in activities of daily life. The Foot Posture Index in all nonoperated patients showed a relative shift toward pronation with increased foot length compared with the noninjured foot. The operated patients showed no difference in foot length but minimal shift into supination with a slightly altered arch contour. Surgical repair of plantar fascia ruptures is technically feasible to restore normal foot load capability with return to high-demand plyometric sports within 12 months.
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NewsBot · Dec 16, 2020

Ruptures of the Plantar Fascia: A Systematic Review of the Literature
Massimiliano Mosca et al
Foot Ankle Spec. 2020 Dec 14

Introduction: Rupture of the plantar fascia is a rare condition. It can also occur spontaneously and with no history of disease of the plantar fascia, above all in athletes. This review aims to systematically analyze all cases described in the literature regarding the rupture of the plantar fascia, evaluating incidence, risk factors, and treatments, considering which procedures show the best outcomes and the highest success rate.

Materials and methods: A systematic review of PubMed, Google Scholar, and Cochrane review computerized databases was performed, focusing on articles about cases of rupture of the plantar fascia; 18 studies fulfilled all the criteria and were analyzed. There were no randomized controlled trials.

Results: A total of 155 patients (157 foot) were included in this systematic review. Considering all the studies included, 12 patients had a spontaneous rupture, 138 patients had a diagnosis of plantar fasciitis, and 130 patients were treated with local injections of corticosteroid before the rupture. Only 2 cases of bilateral rupture were reported. In all, 15 studies reported conservative treatment, with a total of 154 patients (156 feet) included. Operative treatment was reported in 3 studies, with 3 patients (3 feet) treated.

Conclusions: Ruptures of the plantar fascia are very rare in asymptomatic patients and more common in patients treated with injection of steroids in the plantar fascia. Conservative treatment, although not standardized in the literature, led to good outcomes in most cases. Chronic ruptures of the fascia should be considered for operative treatment.
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NewsBot · Aug 29, 2022

Surgical Reconstruction with Tendon Allografting Following Iatrogenic Rupture of the Plantar Fascia: A Case Report
Chien-Ming Chin et al
Medicina (Kaunas). 2022 Aug 10;58(8):1075

Plantar fasciitis is a common cause of heel pain, and the disorder is generally self-limiting after adequate conservative treatment. When conservative treatment is unsuccessful, surgical release is an effective treatment option. Here we report a case of iatrogenic plantar fascia rupture after surgical release for treatment of recalcitrant plantar fasciitis. Preoperative MRI revealed a 4.2 cm gap between the distal fascia stump and the calcaneal tuberosity in the sagittal view at 8 months post-injury. To circumvent the possibility of rupture site retear or poor tissue healing by direct repair, we used tendon allografting for the reconstruction of the chronic plantar fascia rupture. The patient gradually recovered after the surgery. Complications of plantar fascia rupture after surgical release is a potential risk but rarely observed. Chronic plantar fascia rupture with medial arch collapse is difficult to treat. We used a tendon allograft to reconstruct the plantar fascia, restoring its function and mechanical strength. After 5 years of follow-up, no complications were reported, and magnetic resonance imaging indicated the reconstructed plantar fascia tissue to be in good condition.
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NewsBot · Aug 29, 2022

Surgical Reconstruction with Tendon Allografting Following Iatrogenic Rupture of the Plantar Fascia: A Case Report
Chien-Ming Chin et al
Medicina (Kaunas). 2022 Aug 10;58(8):1075

Plantar fasciitis is a common cause of heel pain, and the disorder is generally self-limiting after adequate conservative treatment. When conservative treatment is unsuccessful, surgical release is an effective treatment option. Here we report a case of iatrogenic plantar fascia rupture after surgical release for treatment of recalcitrant plantar fasciitis. Preoperative MRI revealed a 4.2 cm gap between the distal fascia stump and the calcaneal tuberosity in the sagittal view at 8 months post-injury. To circumvent the possibility of rupture site retear or poor tissue healing by direct repair, we used tendon allografting for the reconstruction of the chronic plantar fascia rupture. The patient gradually recovered after the surgery. Complications of plantar fascia rupture after surgical release is a potential risk but rarely observed. Chronic plantar fascia rupture with medial arch collapse is difficult to treat. We used a tendon allograft to reconstruct the plantar fascia, restoring its function and mechanical strength. After 5 years of follow-up, no complications were reported, and magnetic resonance imaging indicated the reconstructed plantar fascia tissue to be in good condition.
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NewsBot · Jan 5, 2023

Plantar Fascia Lateral Fascicle Rupture: How Severe Can It Be?
Miguel De Castro Correia, Tiago Rodrigues Lopes
Cureus 14(12): e32987. doi:10.7759/cureus.32987

The plantar fascia is a thick and strong group of longitudinal and transverse bands of collagen-rich tissue, consisting of central, medial, and lateral fascicles. Biomechanically, the central fascicle assumes a special role in medial longitudinal foot arch preservation. However, there is scarce data on plantar fascia medial and lateral fascicles' anatomy and pathology in the literature.

We report the case of a 27-year-old male professional soccer player who presented with sudden-onset, severe lateral right rearfoot pain that had started while doing linear sprinting practice. The athlete had no relevant medical history and no history of previous right foot injuries. The radiographic study of the right foot revealed no significant changes. MRI showed a high T2 signal partially interrupting the plantar fascia lateral fascicle low signal, consistent with a lateral fascicle rupture. The rehabilitation program was initiated and included pharmacological and non-pharmacological management. He experienced an extremely favorable evolution of his condition with the absence of pain and partial weight bearing in less than one week, with a full return to sports in approximately two weeks.

During dynamic foot movement, the lateral fascicle seems to be less biomechanically recruited compared to the central one; however, the strain is not negligible and might be the reason for the pathology. Still, this slightly decreased strain might explain this injury’s faster healing time compared to that associated with the central fascicle. Regarding the risk factors for plantar fascia ruptures, it should be kept in mind that a tear might occur even in their absence.

We intend to raise awareness about the existence of plantar fascia lateral fascicle and the possibility of associated pathology, either acute or chronic. Hopefully, in the near future, plantar fascia ruptures will get significantly more attention in the literature, enabling the creation of proper management guidelines
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NewsBot · May 16, 2023

Acute Rupture of the Plantar Fascia in a Soccer
Player
Diogo Costa et al
Cureus 15(5)

Acute rupture of the plantar fascia is a rare but potentially debilitating injury in athletes, particularly those
involved in running and jumping sports. Early recognition and prompt treatment are crucial for a successful
recovery and return to play. Conservative treatment, including rest, immobilization, and physical therapy,
may be effective in most cases, while surgical intervention may be required in those that are nonresponsive
to conservative treatment.
We report a case of plantar fascia rupture in a 22-year-old male semi-professional football player who
presented with sudden severe pain in the sole of his right foot during a match, followed by a popping
sensation and inability to weight bear. The athlete was healthy and had no history of previous injury in the
right foot. MRI confirmed a complete rupture of the plantar fascia. The player was treated conservatively and
underwent a rehabilitation program. The player returned to full competition after nine weeks, with no
limitations.
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