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Hi folks,

by my own admission biomechanics is not my strongest area. To many im sure the answer to this question is obvious. But if you dont ask you'll never learn.

If the plantar fascia is ruptured or a patient undergoes a fasciotomy (never come across a patient with either of these) will there be a complete arch collapse or just a slight reduction in arch height?

will the arch retain some of its height due to bony allignment and the small intrinsic muscles of the foot?


ross

 

There should be a reduction, rather than collapse, but as time goes on the arch height will reduce further, due to increased loads on other soft tissue and then plastic deformation of the arch height supporting structures . How long that time is in of course patient specific, days, weeks, months or years

Similar story with adult acquired flat deformity which results from Tibialis Posterior issue, once the tendon of the tib post does not "work" as effectively , the deltoid ligaments will have increased loads to control STJ Pronation, they will do some of the job of the tib Post until they too stretch (go through plastic deformation ) and the foot will change it RCSP once again , basically soft tissue will be effected 1st, then bone until Ground force reaction is all that is left.


Hope that helps

 

thanx for that mike.. very helpful

 

Agree with Mike here. When a student many years ago, we progressively stripped a cadaver foot of all it's muscles and ligaments and had a 168lb colleague stand on it. Interestingly, with only the capsular ligaments in situ, it still supported the weight although the ligaments did begin to shear. Not very scientific but interesting. However, although we can live without the PF, it is there for a purpose and fasciotomy will inevitably result in excessive tensile and shearing stress on the long and short plantar ligaments as well as the TP. The foot will eventually deform (or conform to the stresses). This is why most pod surgeons will try to section the medial band only of the PF in extreme cases of P.Fasciitis.

All the best

Bill

PS No such thing as a stupid question

 

The engineering concept is called redundancy. There is more than one structure that is holding the arch up. Tension in the plantar ligaments at each joint will also hold the arch up.

Eric

 

in 35 yrs of podiatric pratcice
I have seen 4 Plantar facailia ruptures.
Three were icaused by my
ijection of Triamcinalone acetonite 10 MGs
and i once treated a miidle age bus driver whom ruptuted his fascia playing basket bal.
ALL of hese patients reported no pain 6-8 weeks regardless of treatment.
I still she these patients today with no decrease in the medial longitudinal arch of the affected foot
S.Levitz