Surgery for heel pain

NewsBot · Sep 25, 2008

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Clinical outcome of surgical intervention for recalcitrant infero-medial heel pain.
Sinnaeve F, Vandeputte G.
Acta Orthop Belg. 2008 Aug;74(4):483-8.

A retrospective review was conducted in 28 patients (31 feet) with recalcitrant infero-medial heel pain, to assess the clinical outcome of a combined release of the first branch of the lateral plantar nerve and the plantar fascia. All patients were questioned by telephone interview on their pre- versus post-operative level of pain and function (based on the Kitaoka mid-foot scale and the visual analog scale), and their satisfaction with the result of the intervention. Limitations of functional activity decreased, maximum walking distance increased and the level of pain decreased from 8.9 to 1.4 on the visual analog scale. The majority of patients was satisfied with the surgery (90.3%) and would undergo the same procedure again or would recommend it (92.9%). While conservative management remains the gold standard for treatment of infero-medial heel pain and/or plantar fasciitis, patients with recalcitrant disease usually can be effectively treated surgically with a combined release of the plantar fascia and the first branch of the lateral plantar nerve.
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Admin2 · Sep 26, 2008

Related thread:
Endoscopic Partial Plantar Fasciotomy for Plantar Fasciitis

NewsBot · Jan 30, 2010

Percutaneous surgery for plantar fasciitis due to a calcaneal spur
Apóstol-González S, Herrera J.
Acta Ortop Mex. 2009 Jul-Aug;23(4):209-12.

OBJECTIVE: Determine the efficacy of percutaneous surgical treatment for talalgia due to a calcaneal spur.

MATERIAL AND METHODS: This is an observational, descriptive, clinical series analyzing the outcomes of 10 patients with a diagnosis of talalgia due to plantar fasciitis with a calcaneal spur treated with percutaneous foot surgery. The end result was assessed with a visual analog scale (VAS) to measure pain, the patients' opinion and their return to activities of daily living. Central tendency and scatter measurements were calculated. The inferential analysis was done with the non-parametric chi square (chi2) test.

RESULTS: Most patients were females (90%) and mean age was 40.5 years. Follow-up was 12 months. One patient had bleeding of the approached area. Pain was reduced from 8 to 1.5 in the VAS. Nine patients returned to their activities. Two patients had occasional mild pain upon prolonged bipedestation. Ninety percent of results were satisfactory.

CONCLUSIONS: Percutaneous foot surgery in talalgias caused by plantar fasciitis due to a calcaneal spur is a simple and effective method. It reduces the operative time and allows for an early return of patients to their activities of daily living.
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NewsBot · Mar 24, 2010

Calcaneal osteotomy for the treatment of plantar fasciitis.
Miyamoto W, Takao M, Uchio Y.
Arch Orthop Trauma Surg. 2010 Feb;130(2):151-4.

BACKGROUND: Plantar fascia release is the main procedure for plantar fasciitis which does not respond to conservative treatment. However, this procedure is sometimes accompanied by lateral column pain due to loss of the longitudinal arch height after surgery. To avoid this complication, we performed calcaneal osteotomy. The aim of this study was to clarify the efficacy of this procedure.

METHODS: A retrospective clinical and radiographic study was conducted for 11 patients (11 feet) who had undergone calcaneal osteotomy for the treatment of intractable plantar fasciitis. Three of the patients were males and eight were females, with an average age of 46 (range 24-70) years. Calcaneal osteotomy was performed from 1 cm anterior of the calcaneal attachment of the plantar fascia to 1 cm anterior of the calcaneal attachment of the Achilles tendon, and the proximal fragment was displaced approximately 5 mm in the plantar direction. The patients with a pronated foot before surgery underwent an additional approximately 5 mm medial displacement of the proximal fragment.

RESULT: Significant improvement was seen between the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score before surgery and at final follow-up (P < 0.0001). With regard to the radiographic parameters which evaluated longitudinal arch height, significant improvement was seen between the talar pitch (P = 0.0002), calcaneal plantar angle (P < 0.0001) and lateral talocalcaneal angle (P = 0.0251) before and at 2 years after surgery. One patient with severe pes planus before surgery showed poor clinical and radiographic results.

CONCLUSIONS: This procedure can bring about good results in patients who do not have severe pes planus.
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NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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