Our experiences with the surgical treatment of plantar fasciitis
ABSTRACT The authors present the results of surgical treatment of plantar fasciitis done at the University of Debrecen, Department
of Orthopaedics, between 1996 and 2004 on 52 feet of 42 patients. The surgical indication was heel pain unresponsive to at
least 6months of conservative treatment with the exclusion of all differential diagnosis. During surgery, the partial detachment
of the plantar aponeurosis origin was performed. The American Orthopaedic Foot and Ankle Society score was used for assessment.
The average preoperative score of 43 increased to 85 postoperatively. Postoperatively 69% of the patients had excellent (86–100),
12% good (71–85), 4% average (61–70) and 15% had bad (fewer than 60) results. The patients 66% was very satisfied, 11% was
satisfied, 12% was slightly satisfied, and 11% was unsatisfied with the surgical result. Based on our retrospective study,
we recommend the surgical treatment of plantar fasciitis unresponsive to conservative treatment.
KeywordsPlantar fasciitis-Surgical treatment-Retrospective study-Heel pain
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ABSTRACT: It is believed that obese individuals may have an increased number of foot and ankle problems. The World Health Organization recommends a standard classification of adult overweight and obesity using the following body mass index (BMI) calculations: a BMI of 25.0 to 29.9 kg per m(2) is defined as overweight; a BMI of 30.0 kg per m(2) or more is defined as obesity. The purpose of this paper was to report a survey of 1411 patients in an orthopaedic foot and ankle practice and compare the incidence of orthopaedic foot and ankle complaints with the BMI. One thousand four hundred and eleven adults, including 887(62.4%) women and 535(37.6%) men, were evaluated in this study. The BMI was calculated for each subject using the standards of the World Health Organization. The subjects were divided into two groups: normal and overweight. The normal weight subjects had a BMI of 18.5 to 24.9 (n = 684; 48.1%) and the overweight or obese group had a BMI greater than or equal to 25 (n = 738; 51.9%). In this study, being overweight or obese significantly increased the chances of having tendinitis in general. If the subjects were overweight or obese, there was an increased likelihood, although not significant, of plantar fasciitis and osteoarthritis. If the individuals were of normal weight, there was an increased likelihood of hallux valgus. Tendinitis, plantar fasciitis, and osteoarthritis usually are secondary to overuse and increased stress on the soft tissues and joints, which may be directly related to increased weight on these structures.Foot & Ankle International 10/2007; 28(9):996-9. · 1.63 Impact Factor
Article: Plantar fasciitis.[Show abstract] [Hide abstract]
ABSTRACT: The plantar fascia runs from the medial tubercle of the calcaneus to the transverse ligaments of the metatarsal heads of the foot. The fascia has medial, central, and lateral parts, underneath which lie the abductor hallucis, flexor digitorum brevis, and flexor digiti minimi muscles, respectively. It holds down muscles and tendons in the concave surface of the sole and digits, facilitates excursion of the tendons, prevents excessive compression of digital vessels and nerves, and possibly aids in venous return (1). The origin of this fibrous aponeurosis is rich in sensory innervation and has fibrocartilage with longitudinal collagen fibers that resist tension. This fibrocartilage is also metabolically active in forming cartilage. Overuse of this structure can lead to a condition known as plantar fasciitis. Because fascia has little elastic properties, repetitive stretching can cause microtears at its origin.Orthopedics 11/1993; 16(10):1153-63. · 0.98 Impact Factor
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ABSTRACT: In a previous investigation, eighty-two patients with chronic proximal plantar fasciitis for a duration of more than ten months completed a randomized, prospective clinical trial. The patients received instructions for either a plantar fascia-stretching protocol or an Achilles tendon-stretching protocol and were evaluated after eight weeks. Substantial differences were noted in favor of the group managed with the plantar fascia-stretching program. The goal of this two-year follow-up study was to evaluate the long-term outcomes of the plantar fascia-stretching protocol in patients with chronic plantar fasciitis. Phase one of the clinical trial concluded at eight weeks. At the eight-week follow-up evaluation, all patients were instructed in the plantar fascia-stretching protocol. At the two-year follow-up evaluation, a questionnaire consisting of the pain subscale of the Foot Function Index and an outcome survey related to pain, function, and satisfaction with treatment was mailed to the eighty-two subjects who had completed the initial clinical trial. Data were analyzed with use of a mixed-model analysis of covariance for each outcome of interest. Complete data sets were obtained from sixty-six patients. The two-year follow-up results showed marked improvement for all patients after implementation of the plantar fascia-stretching exercises, with an especially high rate of improvement for those in the original group treated with the Achilles tendon-stretching program. In contrast to the eight-week results, the two-year results showed no significant differences between the groups with regard to the worst pain or pain with first steps in the morning. Descriptive analysis of the data showed that 92% (sixty-one) of the sixty-six patients reported total satisfaction or satisfaction with minor reservations. Fifty-one patients (77%) reported no limitation in recreational activities, and sixty-two (94%) reported a decrease in pain. Only sixteen of the sixty-six patients reported the need to seek treatment by a clinician. This study supports the use of the tissue-specific plantar fascia-stretching protocol as the key component of treatment for chronic plantar fasciitis. Long-term benefits of the stretch include a marked decrease in pain and functional limitations and a high rate of satisfaction. This approach can provide the health-care practitioner with an effective, inexpensive, and straightforward treatment protocol.The Journal of Bone and Joint Surgery 09/2006; 88(8):1775-81. · 4.31 Impact Factor