Endoscopic Plantar Fascia Release: A Cross-sectional Anatomic Study

1997 ◽  
Vol 18 (7) ◽  
pp. 398-401 ◽  
Author(s):  
Fredrick Reeve ◽  
Richard T. Laughlin ◽  
Douglas G. Wright
Keyword(s):  
Average Distance ◽  
Plantar Fascia ◽  
Anatomic Study ◽  
Abductor Hallucis ◽  
Cross Sectional ◽  
Abductor Hallucis Muscle ◽  
Fresh Frozen ◽  
Abductor Digiti Minimi ◽  
The Relationship ◽  
Plantar Fascia Release

Endoscopic plantar fascia release is a new procedure proposed to treat heel pain and plantar fasciitis. The purpose of this study was to assess the structures at risk during plantar fascia release using this method. Ten fresh-frozen cadaver feet were divided into two groups. All specimens underwent cannula placement inferior to the plantar fascia. Five of the specimens had plantar fascia release using the endoscopic technique. Six of the specimens were then frozen and cut in transverse, sagittal, and coronal sections to visualize the relationship between the cannula and plantar fascia and surrounding structures. Gross dissection was performed on the remaining four specimens. The amount of plantar fascia released, the relationship to the nerve to abductor digiti minimi, and the fascia of the abductor hallucis muscle were assessed. The average distance from the cannula margin to the nerve to the abductor digiti minimi was 6 mm at the medial border of the plantar fascia. The average amount of plantar fascia released was 90%. Although a complete release was attempted, the fascia to the abductor hallucis was not released in any of the specimens. The nerve to the abductor digiti minimi was not damaged in any of the specimens. On coronal sections, the nerve was closer to the cannula and plantar fascia release than previously reported.

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.

Endoscopic Plantar Fascia Release: An Anatomical Study

1995 ◽  
Vol 16 (11) ◽  
pp. 719-723 ◽  
Author(s):  
Eric P. Hofmeister ◽  
Michael J. Elliott ◽  
Paul J. Juliano
Keyword(s):  
Average Distance ◽  
Anatomical Study ◽  
Plantar Fascia ◽  
Average Amount ◽  
Lateral Plantar Nerve ◽  
Flexor Digitorum Brevis ◽  
Fresh Frozen ◽  
Abductor Digiti Minimi ◽  
Relationship Of ◽  
Neurovascular Structures

The anatomical relationship of neurovascular structures to the plantar fascia after endoscopic fasciotomy was studied in 13 adult fresh-frozen cadaver feet. Using a single portal technique, an endoscopic system was placed into the plantar compartment through a 1-cm medial incision. Under direct endoscopic visualization, the plantar fascia was released. The feet were then dissected and the anatomic relationship of the neurovascular structures to the area of release was studied. The average amount of plantar fascia released was 81%. The average distance of the release to the lateral plantar nerve, and the nerve to the abductor digiti minimi was 10.5 and 12.3 mm, respectively. The flexor digitorum brevis muscle was partially transected in 46% of the cases, and the average amount of muscle transected was 0.8 mm. The endoscopic approach to the release of the plantar fascia provides adequate release and does not appear to pose any danger to underlying neurovascular structures.

Spatial distribution of gambling: two indexes in support of the reduction of health inequalities

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Papineau ◽  
E Robitaille ◽  
C Prisca Samba ◽  
F Lemétayer ◽  
Y Kestens ◽  
...  
Keyword(s):  
Relative Risk ◽  
Average Distance ◽  
Spatial Accessibility ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Treatment Services ◽  
Risk Monitoring ◽  
Dissemination Area ◽  
Interactive Map ◽  
The Relationship

Abstract Background Many studies have showed that disadvantaged areas residents have greater access to gambling sites and are more affected by gambling. Our research proposes an innovative method to characterize gambling environments in Quebec and addresses social inequality with respect to gambling exposure. Methods This cross-sectional ecological study was carried out in 3 stages: a Gambling Exposure Index (GEI) was built and is composed of 3 dimensions: spatial accessibility to gambling sites, density of gambling places, and relative risk associated with the types of game. The two-step floating catchment area (2SFCA) method was used to combine these dimensions into an overall GEI index. Data was retrieved from a geocoded directory of gambling sites and commercial databases. The relative risk of games is expressed by prevalence rates for those specific games in a Quebec population prevalence survey. A Vulnerability to Gambling Index (VGI) was produced based on 6 socio-economic proxies of problem gambling from the 2016 Canadian census, which were weighted and aggregated at the dissemination area (DA) level. Spatial and descriptive statistical analyses were conducted to explore the relationship between VGI and GEI, and to identify highly exposed and vulnerable areas. Results Our analyzes reveal significant associations between the GEI and the VGI in 2 599 out of 13 420 Quebec DAs (p < 0.05). Sectors with a high GEI show an average distance to the closest gambling sites of 2.8 km compared with 13.5 km for more advantaged sectors. Conclusions The interactive online mapping of the two indexes and statistical analysis of the results are beneficial to the professionals working in several fields such as risk monitoring, management of zoning, licensing and gambling distribution, prevention and treatment services. The method and the associated tools can be adapted to address the problem of increased accessibility to other unhealthy products in vulnerable neighborhoods. Key messages Two innovative ecological indexes show that increased accessibility to gambling correlates with a higher vulnerability to gambling in many Quebec regions. The online interactive map on gambling exposure and vulnerability provides reliable criteria to municipal, regional and governmental bodies for a safer distribution of gambling offer.

scholarly journals Medial Soft-tissue Release for a Lateralising Calcaneal Osteotomy

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Kalpesh Shah ◽  
Kumar Kaushik Dash
Keyword(s):  
Plantar Fascia ◽  
Lateral Shift ◽  
Soft Tissue Release ◽  
Abductor Hallucis ◽  
Pes Cavus ◽  
Flexor Retinaculum ◽  
Calcaneal Osteotomy ◽  
Before And After ◽  
Abductor Hallucis Muscle ◽  
Muscle Fascia

Category: Hindfoot Introduction/Purpose: Lateralising calcaneal osteotomy (LCO) for pes cavus is generally regarded to be harder to shift than a medialising calcaneal osteotomy for pes planus. Whilst this may be due to tight tissues as in pes cavus, no attempt has been made to define a particular structure that could limit the lateral shift in a LCO. Some surgeons recommend releasing the flexor retinaculum routinely with a LCO to avoid a tarsal tunnel syndrome, suggesting that perhaps it is the flexor retinaculum that is the main restrictor to the lateral shift in a LCO. The purpose of our study was to define the structures that restrain the lateral shift in a calcaneal osteotomy in a cadaveric study. Methods: Calcaneal osteotomies were carried out by a single orthopaedic surgeon on 10 embalmed, below-knee cadavers. LCOs were performed using standard lateral approach and the lateral calcaneal shift was measured before and after the release of flexor retinaculum in 4 cadavers. Further exploratory dissection around the osteotomy site, however, revealed that abductor hallucis muscle must be the main restraint to the lateral shift of the calcaneus. Subsequently, LCO was performed on another 6 cadavers and the abductor hallucis muscle fascia as well as the plantar fascia was released. The lateral shift was measured before and after the fascia releases, and compared with those of the flexor retinaculum release. Results: The average shift with a LCO by itself in the first 4 cadavers was similar to the last 6 (4.5 mm and 5.5 mm respectively). Releasing the flexor retinaculum created a further 3 mm lateral shift on average; however, release of abductor hallucis muscle fascia and the plantar fascia increased lateral shift by an additional 7 mm on average; which is an extra 4 mm shift on average compared with those of flexor retinaculum release. Conclusion: The results of this study suggest that the abductor hallucis muscle along with the plantar fascia is one of the main structures limiting the lateral shift in LCO, and release of fascia over this muscle as well as the plantar fascia should be an essential part of the lateralizing calcaneal osteotomy.

scholarly journals TL 18165 - Relationship between lower limb dysmetria and plantar fasciitis

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 96S
Author(s):  
Henrique Mansur ◽  
Guilherme Gonçalves Feijó Carvalho ◽  
Isnar Moreira de Castro Júnior
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Calcaneal Spur ◽  
The Mean ◽  
The Relationship

Introduction: Plantar fasciitis is an inflammatory process of multifactorial etiology that affects the origin of the plantar fascia and surrounding structures. A difference in length between lower limbs is relatively common within the population and can sometimes cause changes in biomechanics and symptoms. The objective of this study is to evaluate the relationship between lower limb dysmetria and plantar fasciitis. Methods: A cross-sectional study was performed to measure the length of the lower limbs by scanometry in patients diagnosed with plantar fasciitis. Other risk factors, such as body mass index, foot shape and the presence of plantar calcaneal spur, were also assessed in foot radiographs. Results: Of the 54 patients included in the study, 44.4% were men, and the mean age was 50.38 (23-73 years); 81.5% had pain in one foot, and 53.7% had feet that were considered plantigrade. We observed dysmetria in 88.9% of the sample, with a mean of 0.749 cm (SD ±0.63). In addition, 46.3% feet with pain showed calcaneal spurs on the radiographs. Conclusion: Approximately 90% of patients showed lower-limb dysmetria and, in most cases, the side with the shorter limb was affected by plantar fasciitis

scholarly journals Morphological characteristics of intrinsic foot muscles among flat foot and normal foot using ultrasonography_

2020 ◽  
Vol 22 (4) ◽  
Author(s):  
Kodai Sakamoto ◽  
Shintarou Kudo
Keyword(s):  
Body Height ◽  
Morphological Characteristics ◽  
Lateral Position ◽  
Abductor Hallucis ◽  
Flat Foot ◽  
Cross Sectional ◽  
Flat Feet ◽  
Abductor Digiti Minimi ◽  
Intrinsic Foot Muscle ◽  
Adductor Hallucis

Purpose: The purpose of this study was to compare the morphology of the intrinsic foot muscle between typical foot and flat foot with the use ultrasound. Methods: Thirty-seven healthy participants were recruited in this study. Foot types were classified using the Foot posture index 6-item version. A total of 43 flat feet and 31 typical feet were examined. Using B-mode ultrasound imaging, the morphology of the abductor hallucis, oblique head of adductor hallucis, abductor digiti minimi, and flexor digitorum brevis muscles were measured. Morphology of all muscles measured was normalized by body height. The independent Student’s t-test was used to examine the differences in the thickness and the cross-sectional area (CSA) of the intrinsic foot muscle among the two groups. Results: The thickness of abductor hallucis was significantly larger in flat foot group. The thickness and CSA of abductor digiti minimi and the thickness of oblique head of adductor hallucis were significantly smaller in flat foot group. Conclusions: Our results showed hypertrophied adductor hallucis, atrophied abductor digiti minimi, and atrophied oblique head of the adductor hallucis in individuals with flat feet, suggesting a possible tendency to hypertrophy in muscles that are located in a medial position and a possible tendency to atrophy in muscles that are located in a lateral position in flat feet.

Mechanical Behavior of the Foot and Ankle After Plantar Fascia Release in the Unstable Foot

1997 ◽  
Vol 18 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Harold B. Kitaoka ◽  
Zong Ping Luo ◽  
Kai-Nan An
Keyword(s):  
Three Dimensional ◽  
Plantar Fascia ◽  
Three Dimensions ◽  
Arch Height ◽  
Average Decrease ◽  
Human Foot ◽  
Tarsal Bones ◽  
Fresh Frozen ◽  
Tracking Device ◽  
Plantar Fascia Release

The change in position of the bones of the foot was studied in three dimensions after plantar fascia release in intact and destabilized feet. Fifteen fresh-frozen human foot specimens were used. Physiologic loads of 445 newtons were applied axially to simulate standing at ease, and the three-dimensional position of tarsal bones was determined with a magnetic tracking device. The positions were presented in the form of screw axis displacements, quantitating rotation, and axis of rotation orientation. After fasciotomy in the six intact feet, significant differences in rotation were observed at the talotibial and calcaneotalar levels. After fasciotomy in the four unstable feet with three supporting elements sectioned, significant differences in position were observed at the talotibial joint and a significant decrease in arch height was observed. After fasciotomy in the five unstable feet with five supporting elements sectioned, significant differences in rotation were observed at the talotibial joint (mean, 5.5 ± 1.6° P = 0.001), calcaneotalar joint (mean, 6.1 ± 2.1° P = 0.003), and metatarsotalar level (mean, 9.3 ± 4.1° P = 0.007). The average decrease in arch height was 7.4 ± 4.1 mm ( P = 0.015). Displacement of all joints tested occurred after fasciotomy, with rotation about all three axes. These changes in displacement were more pronounced in unstable or destabilized feet. The data suggest that operations involving fasciotomy affect arch stability and should not be performed in patients with evidence of concomitant pes planus deformity, because of the likelihood of further deformation.

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