Percutaneous plantar fasciotomy: radiological evolution of medial longitudinal arch and clinical results after one year

Background: Plantar fascia release for chronic plantar fasciitis has provided excellent pain relief and rapid return to activities with few reported complications. Cadaveric studies have led to the identification of some potential postoperative problems, most commonly weakness of the medial longitudinal arch and pain in the lateral midfoot. Methods: An electronic search was conducted of the MEDLINE, ScienceDirect, SportDiscus, EMBASE, CINAHL, Cochrane, and AMED databases. The keywords used to search these databases were plantar fasciotomy and medial longitudinal arch. Articles published between 1976 and 2008 were identified. Results: Collectively, results of cadaveric studies suggested that plantar fasciotomy leads to loss of integrity of the medial longitudinal arch and that total plantar fasciotomy is more detrimental to foot structure than is partial fasciotomy. In vivo studies, although limited in number, concluded that although clinical outcomes were satisfactory, medial longitudinal arch height decreased and the center of pressure of the weightbearing foot was excessively medially deviated postoperatively. Conclusions: Plantar fasciotomy, in particular total plantar fasciotomy, may lead to loss of stability of the medial longitudinal arch and abnormalities in gait, in particular an excessively pronated foot. Further in vivo studies on the long-term biomechanical effects of plantar fasciotomy are required. (J Am Podiatr Med Assoc 99(5): 422–430, 2009)

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Comparison of three types of postoperative management for endoscopic plantar fasciotomy. A retrospective study

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-90-5-247 ◽

2000 ◽

Vol 90 (5) ◽

pp. 247-251 ◽

Cited By ~ 7

Author(s):

BJ Zimmerman ◽

MD Cardinal ◽

MD Cragel ◽

AR Goel ◽

JW Lane ◽

...

Keyword(s):

Retrospective Study ◽

Pain Relief ◽

Postoperative Management ◽

Medial Longitudinal Arch ◽

Postoperative Results ◽

The Third ◽

Below The Knee ◽

Longitudinal Arch ◽

Plantar Fasciotomy

This study compared three types of postoperative management of patients undergoing endoscopic plantar fasciotomy. Participating in the study were 38 patients (45 feet) who had undergone endoscopic plantar fasciotomy from 1995 to 1998. One group of patients wore a below-the-knee walking cast with a molded medial longitudinal arch for 2 weeks; another group was allowed immediate plantigrade weightbearing; the third group was nonweightbearing with crutch-assisted ambulation for 2 weeks. The results showed that the patients who wore the below-the-knee walking cast for 2 weeks required less time to obtain 80% pain relief, needed less time to return to full activities, and had fewer complications than those patients who were allowed immediate plantigrade weightbearing. Moreover, patients who wore the below-the-knee walking cast were more satisfied with their postoperative results than patients who were nonweightbearing for 2 weeks.

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