Endoscopic Plantar Fascia Release: A Case Series

2003 ◽  
Vol 24 (2) ◽  
pp. 176-179 ◽  
Author(s):  
R.A. Boyle ◽  
G.L. Slater
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Plantar Fascia ◽  
Subjective Assessment ◽  
Heel Pain ◽  
Walking Distance ◽  
Reliable Procedure ◽  
Plantar Fascia Release ◽  
Partial Release

Plantar fasciitis is a common disabling condition that can be recalcitrant to treatment. Endoscopic Plantar Fascia Release (EPFR) has received greater attention in recent years as a viable, and possibly superior, alternative to established open procedures for the treatment of plantar fasciitis. In a series of 17 patients (17 feet) with follow-up over an average of 16 months, we report a two portal endoscopic technique of partial release of the plantar fascia, as a successful, safe and reliable procedure for the treatment of plantar fasciitis in the patient group selected. The surgical results of 17 EPFR's performed by the same surgeon were reviewed. All patients had preoperative symptoms of subcalcaneal heel pain for greater than 12 months, all having undergone nonsurgical measures for at least 12 months. Of 17 feet, all reported marked improvement of preoperative symptoms within two months. Patients' subjective assessment of the procedure was strongly supportive, 100% totally satisfied or satisfied with only minor restrictions. Postoperatively, 82.4% reported mild or no pain, and 100% had improvement in walking distance. Complications all resolved within two to six months; there were no re-operations and no infections.

scholarly journals A novel closed technique for ultrasound-guided plantar fascia release with a needle: review of 107 cases with a minimum follow-up of 24 months

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
A. Iborra ◽  
M. Villanueva ◽  
P. Sanz-Ruiz ◽  
Antonio Martin ◽  
Concepción Noriega
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Rehabilitation Program ◽  
Heel Pain ◽  
Ultrasound Guided ◽  
Lateral Column ◽  
Guided Surgery ◽  
Plantar Fasciotomy ◽  
Plantar Fascia Release

Abstract Background This study aims to analyze the clinical outcome of a new ultrasound-guided surgery for partial plantar fasciotomy performed with a needle for treatment of plantar fasciitis. Methods We performed a retrospective review of 107 patients diagnosed with plantar fasciitis who underwent ultrasound-guided release of the plantar fascia. The series included 62 males (57.9%) and 45 females (42.1%) treated between April 2014 and February 2018, with a mean follow-up of 21.05 ± 10.96 months (7–66) and a minimum follow-up of 24 months. The mean age was 48.10 ± 10.27 years (27–72). Clinical assessments and ultrasound examination were carried out before treatment, after 1 week, and then after 1, 3, 12, and 24 months. The clinical assessment was based on a visual analog scale and the Foot and Ankle Disability Index. Results Heel pain improved in 92.5% (99) of patients, but not in 7.4% (8 patients). In the group of patients whose heel pain improved, 9 experienced overload on the lateral column and dorsum of the foot, which improved with the use of plantar orthoses and a rehabilitation program. We recorded no nerve complications (e.g., paresthesia), vascular injuries, or wound-related problems. Conclusion Ultrasound-guided partial plantar fasciotomy with a needle is safe, since structures are under direct visualization of the surgeon and the risk of damage is minimal. Stitches are not necessary, and recovery is fast. Consequently, costs are low, and the patient can return to work quickly. This technique may represent a valid option for treatment of plantar fasciitis.

scholarly journals Reduction in Plantar Heel Pain and a Return to Sport After a Barefoot Running Intervention in a Female Triathlete With Plantar Fasciitis

2017 ◽  
Vol 22 (5) ◽  
pp. 26-32 ◽  
Author(s):  
Peter Francis ◽  
Cassie Oddy ◽  
Mark I. Johnson
Keyword(s):  
Conservative Treatment ◽  
Plantar Fasciitis ◽  
Case Series ◽  
Return To Sport ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Barefoot Running ◽  
Plantar Heel Pain ◽  
First Case

In a 27-year-old female triathlete, magnetic resonance imaging revealed mild thickening and edema at the calcaneal insertion of the plantar fascia, in keeping with a degree of plantar fasciitis. After 6 weeks of conservative treatment failed to elicit a return to sport, the patient engaged in six sessions of barefoot running (15–30 min) on a soft grass surface, without further conservative treatment. After two sessions of barefoot running, the patient was asymptomatic before, during, and after running. This outcome was maintained at the 6-week follow-up period. This is the first case report to use barefoot running as a treatment strategy for chronic heel pain. Barefoot running has the potential to reduce the load on the plantar fascia and warrants further investigation using a case series.

An Anatomic Analysis of Endoscopic Plantar Fascia Release

1995 ◽  
Vol 16 (9) ◽  
pp. 552-558 ◽  
Author(s):  
Bryan J. Hawkins ◽  
Richard J. Langermen ◽  
Timothy Gibbons ◽  
Jason H. Calhoun
Keyword(s):  
Plantar Fascia ◽  
Heel Pain ◽  
Deep Fascia ◽  
Abductor Hallucis ◽  
Lateral Plantar Nerve ◽  
Local Structures ◽  
Abductor Hallucis Muscle ◽  
Fresh Frozen ◽  
Plantar Fascia Release ◽  
Partial Release

Eighteen fresh-frozen cadaver foot specimens underwent release of the plantar fascia via a newly described endoscopic technique. A 75% release was attempted on each specimen in order to represent a partial fascial release. Each specimen was then dissected to assess the success of the procedure. Five separate measurements were recorded evaluating the reproducibility of the procedure, adequacy of the release considering accepted etiologies for chronic heel pain, and the possibility of damage to local structures. Partial release was noted to be possible, but controlling the exact percentage of the incision was difficult. The release averaged 82% of the width of the fascia, with a range of 53% to 100%. There was no damage in any specimen to the first branch of the lateral plantar nerve, the structure considered most at risk during the procedure. Release of the deep fascia of the abductor hallucis muscle was not possible with this approach.

Iatrogenic Lateral Plantar Nerve Injury After Endoscopic Plantar Fascia Release: A Case Report

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Yen-Chun Chiu ◽  
Shih-Chieh Yang ◽  
Yu-Hwan Hsieh ◽  
Yuan-Kun Tu ◽  
Shyh-Ming Kuo ◽  
...  
Keyword(s):  
Case Report ◽  
Nerve Injury ◽  
Endoscopic Surgery ◽  
Plantar Fasciitis ◽  
Surgical Intervention ◽  
Plantar Fascia ◽  
Slight Improvement ◽  
Lateral Plantar Nerve ◽  
Plantar Fascia Release

We present a 57-year-old female patient with iatrogenic lateral plantar nerve injury caused by endoscopic surgery for plantar fasciitis. Nerve grafting surgery was recommended, but the patient refused further surgical intervention because of personal reasons. After 1-year follow-up in outpatient clinics, she achieved only slight improvement in the lateral foot symptoms and still required oral analgesics for pain control. The purpose of this case report is to remind physicians of such a rare and serious complication that can occur after endoscopic surgery for plantar fasciitis. Good knowledge of anatomy and skilled surgical technique could decrease this type of complication.

Correlation Between Gastrocnemius Tightness and Heel Pain Severity in Plantar Fasciitis

2020 ◽  
pp. 107110072095514
Author(s):  
Christopher J. Pearce ◽  
Dexter Seow ◽  
Bernard P. Lau
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Heel Pain ◽  
Level Of Evidence ◽  
Data Points ◽  
The Mean ◽  
The Difference ◽  
Night Splint ◽  
Gastrocnemius Tightness

Background: It is known that there is an association between gastrocnemius tightness and plantar fasciitis, but this has never been quantified. The purpose of the study was to determine the correlation between gastrocnemius tightness and the severity of heel pain in plantar fasciitis. Methods: Thirty-three patients were prescribed physiotherapist-directed gastrocnemius stretching exercises, a Strassburg Sock or night splint, and silicone heel insoles as required. Outcome measures included (1) gastrocnemius tightness, (2) 100-mm visual analog scale (VAS) for pain on the first steps in the morning, and (3) 100-mm VAS for the worst pain felt during the previous week. Gastrocnemius tightness was measured by the difference in maximal ankle dorsiflexion between knee bent and straight with a goniometer. Results: The mean gastrocnemius tightness was 22 degrees at baseline compared with 9 degrees at the final follow-up ( P < .01). A reduction in VAS for pain on the first steps in the morning and VAS for the worst pain felt during the previous week from baseline to final follow-up was observed ( P < .01). Correlation analysis of 105 data points between gastrocnemius tightness and VAS for pain on the first steps in the morning was R = 0.757 ( P < .001), and between gastrocnemius tightness and VAS for the worst pain felt during the previous week was R = 0.781 ( P < .001). Conclusion: The study observed a strong, statistically significant correlation between gastrocnemius tightness and the severity of heel pain in plantar fasciitis. Level of Evidence: Level IV, case series.

scholarly journals Comparison of the Therapeutic Outcomes between Open Plantar Fascia Release and Percutaneous Radiofrequency Ablation in the Treatment of Intractable Plantar Fasciitis

2020 ◽  
Author(s):  
Yusong Yuan ◽  
Yuan Qian ◽  
Hao Lu ◽  
Yuhui Kou ◽  
Yangbo Xu ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Plantar Fasciitis ◽  
Recovery Time ◽  
Operative Time ◽  
Plantar Fascia ◽  
Treated Group ◽  
Heel Pain ◽  
Foot And Ankle ◽  
Percutaneous Radiofrequency Ablation ◽  
Plantar Fascia Release

Abstract Background: Heel pain is one of the most common complaints in foot and ankle clinic and one of the leading causes of heel pain is plantar fasciitis. Methods: A retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. In the enrolled 26 cases, there were 16 patients (19 feet) received open plantar fascia release, and the other 15 patients (20 feet) received percutaneous radiofrequency ablation. The surgical results were assessed by visual analogue scale (VAS) and American orthopaedic foot and ankle society ankle-hindfoot scale (AOFAS-AH) before and after surgery in all patients. Results: All 31 patients were followed up successfully, with a mean follow-up time of 58.77 months. There were no differences of patient’s demographics and characteristics information between the two groups. The average operative time of the feet in the open plantar fascia release is longer time than the percutaneous radiofrequency ablation. Furthermore, the percutaneous radiofrequency ablation group had a shorter recovery time to normal activity than the open plantar fascia release group. There were no difference of postoperative VAS scores and the AOFAS-AH scores between the two groups. All patients reported satisfaction after either operation. Conclusion: Symptoms of pain and limb function were significantly improved in patients both of the partial plantar fascia release treated group and the percutaneous radiofrequency ablation treated group. The two types of surgical procedures shared the same long-term curative effects. However, percutaneous radiofrequency ablation was a better technique from the point of shorter operative time and postoperative recovery time.Trial registration: Retrospectively registered.

scholarly journals Comparison of the Therapeutic Outcomes between Open Plantar Fascia Release and Percutaneous Radiofrequency Ablation in the Treatment of Intractable Plantar Fasciitis

2020 ◽  
Author(s):  
Yusong Yuan ◽  
Yuan Qian ◽  
Hao Lu ◽  
Yuhui Kou ◽  
Yangbo Xu ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Plantar Fasciitis ◽  
Recovery Time ◽  
Operative Time ◽  
Plantar Fascia ◽  
Treated Group ◽  
Heel Pain ◽  
Foot And Ankle ◽  
Percutaneous Radiofrequency Ablation ◽  
Plantar Fascia Release

Abstract B ackground : Heel pain is one of the most common complaints in foot and ankle clinic and one of the leading causes of heel pain is plantar fasciitis. Methods : A retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. In the enrolled 26 cases, there were 16 patients (19 feet) received open plantar fascia release, and the other 15 patients (20 feet) received percutaneous radiofrequency ablation. The surgical results were assessed by visual analogue scale (VAS) and American orthopaedic foot and ankle society ankle-hindfoot scale (AOFAS-AH) before and after surgery in all patients. Results: All 31 patients were followed up successfully, with a mean follow-up time of 58.77 months. There were no differences of patient’s demographics and characteristics information between the two groups. The average operative time of the feet in the open plantar fascia release is longer time than the percutaneous radiofrequency ablation. Furthermore, the percutaneous radiofrequency ablation group had a shorter recovery time to normal activity than the open plantar fascia release group. There were no difference of postoperative VAS scores and the AOFAS-AH scores between the two groups. All patients reported satisfaction after either operation. Conclusion: Symptoms of pain and limb function were significantly improved in patients both of the partial plantar fascia release treated group and the percutaneous radiofrequency ablation treated group. The two types of surgical procedures shared the same long-term curative effects. However, percutaneous radiofrequency ablation was a better technique from the point of shorter operative time and postoperative recovery time. Trial registration: Retrospectively registered.

Endoscopic Plantar Fascia Release versus Cryosurgery for the Treatment of Chronic Plantar Fasciitis: A Prospective Randomized Study

2019 ◽  
Vol 110 (5) ◽  
Author(s):  
Bilgehan Çatal ◽  
Ali Bilge ◽  
Ragıp Gökhan Ulusoy
Keyword(s):  
Patient Satisfaction ◽  
Plantar Fasciitis ◽  
Outcome Measurement ◽  
Randomized Study ◽  
Surgical Techniques ◽  
Plantar Fascia ◽  
Prospective Randomized Study ◽  
American Orthopaedic ◽  
Plantar Fascia Release

Background In a prospective randomized study, we compared two different surgical techniques used in plantar fasciitis surgery. Methods Forty-eight patients diagnosed as having plantar fasciitis and treated for at least 6 months with no response to conservative modalities were included in this study. The patients were randomly assigned to receive endoscopic plantar fascia release (EPFR) or cryosurgery (CS). Patients were evaluated using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) as a primary outcome measurement at baseline and 3 weeks and 3, 6, and 12 months after surgery. At the final follow-up visit, the Roles-Maudsley score was used to determine patient satisfaction. Results Five patients did not complete the 1-year follow-up examination (one in the EPFR group and four in the CS group). Thus, the study group included 43 patients. Although both groups showed significant improvement at the final evaluation, the patients in the EPFR group had significantly better AOFAS-AHS scores at 3 months. The success rate (Roles-Maudsley scores of excellent and good) in the EPFR group at 12 months was 87% and in the CS group was 65%. Conclusions Both EPFR and CS were associated with statistically significant improvements at 1-year follow-up. At 3-month follow-up, EPFR was associated with better results and a higher patient satisfaction rate compared with CS.

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

2019 ◽  
Vol 41 (2) ◽  
pp. 187-192
Author(s):  
Ricardo E. Colberg ◽  
Monte Ketchum ◽  
Avani Javer ◽  
Monika Drogosz ◽  
Melissa Gomez ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Plantar Fasciitis ◽  
Case Series ◽  
Successful Outcome ◽  
Oral Steroid ◽  
Tarsal Tunnel ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is the most common cause of heel pain in adults. Multiple conservative treatment plans exist; however, some cases do not obtain significant clinical improvement with conservative treatment and require further intervention. This retrospective case study evaluated the success rate of percutaneous plantar fasciotomy and confounding comorbidities that negatively affect outcomes. Methods: A series of 41 patients treated with percutaneous plantar fasciotomy using the Topaz EZ microdebrider coblation wand were invited to participate in this retrospective follow-up study, and 88% ( N = 36) participated. A limited chart review was completed and the patients answered a survey with the visual analog scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) questionnaire. Average outcomes were calculated and 45 variables were analyzed to determine if they were statistically significant confounders. Patients had symptoms for an average of 3 years before the procedure and were contacted for follow-up at an average of 14 months after the procedure. Results: The average VAS for pain score was 1.3 ± 1.8 and the average FAAM score was 92 ± 15. Eighty-nine percent of patients had a successful outcome, defined as FAAM greater than 75. In addition, patients at 18 months postprocedure reported complete or near-complete resolution of symptoms with an FAAM score greater than 97. Concurrent foot pathologies (eg, tarsal tunnel syndrome), oral steroid treatment prior to the procedure, and immobilization with a boot prior to the procedure were statistically significant negative confounders ( P < .05). Being an athlete was a positive confounder ( P = .02). Conclusion: Percutaneous plantar fasciotomy using a microdebrider coblation was an effective treatment for plantar fasciitis, particularly without concurrent foot pathology, with a low risk of complications. Level of Evidence: Level IV, retrospective case series.

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