Plantar Fasciotomy for Intractable Plantar Fasciitis: Clinical Results and Biomechanical Evaluation*

Thirteen consecutive patients underwent plantar fasciotomy in 16 feet for intractable plantar fasciitis and had follow-up from 4.5 to 15 years. Plantar fasciotomy was successful (good or excellent results) for 71% of the 14 feet operated on and for which follow-up data were available. However, time to full recovery was prolonged, additional treatment was frequently required, and abnormalities of foot function persisted. Flattening of the longitudinal arch occurred. Dynamic force-plate studies showed differences in peak vertical, fore-aft, and lateralmedial forces between patients and matched controls. More rapid progression of weightbearing along the longitudinal axis of the foot during stance phase in patients indicated avoidance of heel loading.

[1]  F. Clippinger,et al.  Proximal Medial Longitudinal Arch Incision for Plantar Fascia Release , 1987, Foot & Ankle.

[2]  J. Furey.  Plantar fasciitis. The painful heel syndrome. , 1975, The Journal of bone and joint surgery. American volume.

[3]  D. Ilstrup,et al.  Radiologic Anatomy of the Painful Bunionette , 1990, Foot & ankle.

[4]  J. Sellman.  Plantar Fascia Rupture Associated with Corticosteroid Injection , 1994, Foot & ankle international.

[5]  R. Jay,et al.  Calcaneal decompression for chronic heel pain. , 1985, Journal of the American Podiatric Medical Association.

[6]  C. L. Jones,et al.  Entrapment neuropathy of muscle branch of lateral plantar nerve: a cause of heel pain. , 1981, Journal of the American Podiatry Association.

[7]  D. Graham,et al.  Painful Heel Syndrome: Radiographic and Treatment Assessment , 1988, Foot & ankle.

[8]  R. Bordelon.  Subcalcaneal pain. A method of evaluation and plan for treatment. , 1983, Clinical orthopaedics and related research.

[9]  R. Leach,et al.  Results of Surgery in Athletes with Plantar Fasciitis , 1986, Foot & ankle.

[10]  D. Baxter,et al.  Heel Pain—Operative Results , 1984, Foot & ankle.

[11]  Polisner Ri.  Early ambulation after minimal incision surgery for calcaneal spurs. , 1985 .

[12]  A. Cracchiolo,et al.  Hindfoot arthrodesis in adults utilizing a dowel graft technique. , 1990, Clinical orthopaedics and related research.

[13]  P. Lapidus,et al.  PAINFUL HEEL: REPORT OF 323 PATIENTS WITH 364 PAINFUL HEELS. , 1965, Clinical orthopaedics and related research.

[14]  D. Lester,et al.  Surgical treatment of plantar fasciitis. , 1984, Clinical orthopaedics and related research.

[15]  L D Lutter,et al.  Surgical decisions in athletes' subcalcaneal pain , 1986, The American journal of sports medicine.

[16]  A. El-Sherif,et al.  Drilling of the os-calcis for painful heel with calcanean spur. , 1974, Acta orthopaedica Scandinavica.

[17]  A. Michele,et al.  Plantar heel pain treated by countersinking osteotomy. , 1951, Military surgeon.

[18]  E. Chao,et al.  Biomechanical analysis of foot function during gait and clinical applications. , 1983, Clinical orthopaedics and related research.

[19]  Michetti Ml,et al.  Calcaneal heel spurs: etiology, treatment, and a new surgical approach. , 1983 .

[20]  H. L. Duvries.  Heel spur (calcaneal spur). , 1957, A.M.A. archives of surgery.

[21]  Kenzora Je.  The painful heel syndrome: an entrapment neuropathy. , 1987 .

[22]  W. Clancy,et al.  Plantar fascia release for chronic plantar fasciitis in runners , 1983, The American journal of sports medicine.

[23]  A. Steindler.  STRIPPING OF THE OS CALCIS , 1920 .

[24]  Robert B. Anderson,et al.  Operative Treatment of Subcalcaneal Pain , 1989, Foot & ankle.

[25]  R. Betts,et al.  Critical light reflection at a plastic/glass interface and its application to foot pressure measurements. , 1980, Journal of medical engineering & technology.

[26]  Health implications of obesity. National Institutes of Health Consensus Development Conference Statement. , 1985, Annals of internal medicine.

[27]  O. Chrisman,et al.  The Management of Subcalcaneal Pain , 1972, Clinical orthopaedics and related research.

[28]  N. Westlin,et al.  Chronic calcaneal pain in athletes: Entrapment of the calcaneal nerve? , 1984, The American journal of sports medicine.

[29]  E. Chao,et al.  Objective Technique for Evaluating Painful Heel Syndrome and Its Treatment , 1983, Foot & ankle.

[30]  Chrisman Od,et al.  The management of subcalcaneal pain. , 1972 .

[31]  Savastano Aa.  Surgical neurectomy for the treatment of resistant painful heel. , 1985 .

[32]  B. Mantell.  Radiotherapy for painful heel syndrome. , 1978, British medical journal.