scholarly journals Evaluation of the Results of Endoscopic Release of Plantar Fascia in Cases of Resistant Chronic Heel Pain

2017 ◽  
Vol 9 (3) ◽  
pp. 209
Author(s):  
Altowijri Albraa Ahmed ◽  
Alshareef Hatim Mohammed A ◽  
Alhasan Ahmed Hassan A ◽  
Mahmoud Ahmed Alqady ◽  
Mohammed G Flemban ◽  
...  
Keyword(s):  
Data Entry ◽  
Plantar Fascia ◽  
Heel Pain ◽  
University Hospital ◽  
Therapeutic Effects ◽  
Aofas Score ◽  
Endoscopic Release ◽  
American Orthopaedic ◽  
Plantar Fasciotomy

AIM: To evaluate the results of endoscopic release of plantar fascia in resistant cases of heel pain.METHODS: An experimental descriptive study involved twenty patients who presented to University hospital with resistant chronic plantar heel pain due to plantar fasciitis, were treated with endoscopic plantar fasciotomy. All patients completed a period of at least six months follow up. Data were collected by the modified American Orthopaedic Foot and Ankle Society (AOFAS) Questionnaire, informed consent was applied, and SPSS was used for data entry and analysis.RESULTS: At the end of follow up the mean modified AOFAS of ankle- hind foot score was improved from 49.10 (ranging from 34 to 56) pre-operatively to 90.25 post operatively (ranging from 67 to 100). Seven patients (35%) had excellent results, ten patients (50%) had good results, two patients had fair results, and one patient (5%) had a poor result. AOFAS score of pain was improved from a mean of 14.0+9.40 points pre-operatively (range 0 – 20) to 31.5 + 6.71 points post-operatively (range 20 – 40). AOFAS score of activity of daily living improved from a mean of 4+0 points pre-operatively to 9.85+0.671post-operatively ranging from 7 to 10 points.CONCLUSION: Endoscopic release of plantar fascia has positive therapeutic effects in cases of resistant chronic heel pain.

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 Effect of extensive tenosynovectomy on diffuse flexor hallucis longus tenosynovitis combined with effusion

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986335 ◽  
Author(s):  
Wenqing Qu ◽  
Tong Liu ◽  
Wentao Chen ◽  
Zhenzhong Sun ◽  
Shengjie Dong ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Final Analysis ◽  
Flexor Hallucis Longus ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Pain Scores ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri ◽  
American Orthopaedic

Objective: The objective of this study was to examine the clinical and magnetic resonance imaging (MRI) outcomes of extensive tenosynovectomy on patients with diffuse flexor hallucis longus tenosynovitis combined with effusion (DFHLT-E). Methods: Consecutive patients undergoing extensive tenosynovectomy for DFHLT-E in the same foot and ankle center from January 2013 to December 2016 were selected; a total of 14 patients were included in the final analysis. Patients with a minimum 1-year follow-up were evaluated with physical examination, MRI, American Orthopaedic Foot and Ankle Society (AOFAS) clinical midfoot scale, and visual analog scale (VAS) pain scores. Results: The 14 patients were followed up for an average of 15.0 ± 2.3 months (12–18 months). There were no recurrences in all clinical examinations at the final follow-up. The AOFAS score was improved from 61.57 ± 10.70 before surgery to 90.28 ± 9.41 at the final follow-up. The difference was statistically significant ( p = 0.001). The VAS score was improved from 4.00 ± 0.82 before surgery to 0.43 ± 0.53 at the final follow-up ( p < 0.001). MRI examination revealed two patients with small residual and limited effusion with no clinical symptoms. Superficial pin infection was observed in one patient, and two patients had transient neurostimulation. Conclusions: Extensive tenosynovectomy is an effective alternative for the treatment of DFHLT-E with less complications or recurrence.

scholarly journals Selective Arthrodesis for Treatment of Symptomatic Müller-Weiss Disease

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0003 ◽  
Author(s):  
Le Cao ◽  
Xu-dong Miao
Keyword(s):  
Ct Scan ◽  
Stage Iv ◽  
Subjective Ratings ◽  
Aofas Score ◽  
Triple Arthrodesis ◽  
Vas Score ◽  
American Orthopaedic ◽  
Hindfoot Arthrodesis ◽  
Old Females

Category: Midfoot/Forefoot Introduction/Purpose: Müller-Weiss Disease (MWD) is also known as Müller-Weiss Syndrome, which is reported an uncommon adult navicular osteonecrosis, frequently occurring in middle-aged and old females and characterized by compression and fragmentation of the lateral aspect of the navicular bone and progressive malformation. In this study, we report the results of selective midfoot and hindfoot arthrodesis for treating symptomatic MWD. Methods: From January 2006 to December 2011, 28 patients (31 feet) with MWD were treated with selective arthrodesis with tricortical autologous iliac crest block fixated by screws and plate and retrospectively reviewed. These included 24 females and 4 males, with an average age of 53.1 years (31-65 years), and an average symptoms duration of 8.6 years (1.5-13 years). The disease was staged according to Maceira, which included 3 feet in stage II, 15 feet in stage III, 7 feet in stage IV, and 6 feet in stage V. Pre- and postoperative visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS), radiologic examination, and patients’ satisfaction rate of the surgery were evaluated at an average of 6.6 years (4-12 years) following surgery. Results: Selective arthrodesis according to various symptoms and CT-scan findings related to MWD, 12 feet had talonavicular arthrodesis, 16 feet had talonavicular-cuneiform arthrodesis, and 3 feet had triple arthrodesis. The follow-up visit showed satisfactory outcomes, solid union was achieved in all cases, with average fusion time was 15.2 weeks (12-26 weeks). VAS score reducing from the preoperative 7.8 (7-9) to postoperative 2.3(0-4), whereas the AOFAS score improved from the preoperative 25.4 (19-42) to the postoperative 80.3 (73-88). The patient’s subjective ratings showed excellent results in 8 feet, good results in 18 feet, and fair outcomes in 5 feet. Conclusion: Selective arthrodesis according to various symptoms and CT-scan findings related to MWD, 12 feet had talonavicular arthrodesis, 16 feet had talonavicular-cuneiform arthrodesis, and 3 feet had triple arthrodesis. The follow-up visit showed satisfactory outcomes, solid union was achieved in all cases, with average fusion time was 15.2 weeks (12-26 weeks). VAS score reducing from the preoperative 7.8 (7-9) to postoperative 2.3(0-4), whereas the AOFAS score improved from the preoperative 25.4 (19-42) to the postoperative 80.3 (73-88). The patient’s subjective ratings showed excellent results in 8 feet, good results in 18 feet, and fair outcomes in 5 feet.

Stiffness and Range of Motion After Minimally Invasive Chevron-Akin and Open Scarf-Akin Procedures

2019 ◽  
Vol 40 (5) ◽  
pp. 515-525 ◽  
Author(s):  
Arno Frigg ◽  
Sandrine Zaugg ◽  
Gerardo Maquieira ◽  
Alex Pellegrino
Keyword(s):  
Minimally Invasive ◽  
Range Of Motion ◽  
Open Surgery ◽  
Aofas Score ◽  
Level Of Evidence ◽  
First Metatarsal ◽  
Level Ii ◽  
American Orthopaedic ◽  
Tissue Trauma

Background: Stiffness after open hallux valgus surgery affects 7% to 38% of patients. Minimally invasive surgery (MIS) is thought to decrease this rate by reducing soft tissue trauma. MIS, now in its third generation, is advertised as delivering results superior to open surgery. However, no studies have reported stiffness or range of motion (ROM). Methods: Between January 2014 and December 2015, a total of 50 patients received open scarf-Akin surgery and 48 received minimally invasive Chevron Akin (MICA) surgery. The endpoints were American Orthopaedic Foot & Ankle Society (AOFAS) score, range of motion, visual analog scale for pain, scar length, and subjective foot value. The minimal follow-up time was 2 years. Results: Moderate stiffness occurred in 3 cases in both groups. In MICA, extension increased by 10 degrees while it remained unchanged in scarf. Both groups showed similar improvements in AOFAS score, pain, and subjective foot value. Radiographic evidence of correction was comparable, except for an increased shortening of the first metatarsal by 3 mm in MICA. The scars were smaller in MICA (1.2 cm) than in scarf (5 cm). Wound problems included delayed healing in 10% in scarf and wound infections in 4% in MICA. The rate of recurrence and other complications were comparable, except for reoperations, which were higher in MICA (27% mainly for protruding screws) than in scarf (8% mainly for stiffness). In MICA, 14% were intraoperatively converted to open surgery. Conclusion: MICA showed no advantages over scarf other than a shorter scar. The observed gain in extension could be related to the increased shortening of the first metatarsal because of the size of the burr. Level of Evidence: Level II, prospective cohort (nonrandomized, comparative) study.

Five-year follow-up results of instep plantar fasciotomy for chronic heel pain

2000 ◽  
Vol 39 (4) ◽  
pp. 218-223 ◽  
Author(s):  
Kirk E. Woelffer ◽  
Michael A. Figura ◽  
Neil S. Sandberg ◽  
Neil S. Snyder
Keyword(s):  
Heel Pain ◽  
Plantar Fasciotomy

scholarly journals The effect of a modified chevron osteotomy for hallux valgus patients: A five-year follow-up study

2021 ◽  
Author(s):  
Shiyong Zhang ◽  
Xue Wang ◽  
Tiannan Chen ◽  
Chengwei Wang ◽  
Jie Wang
Keyword(s):  
Hallux Valgus ◽  
Analog Scale ◽  
Aofas Score ◽  
Intermetatarsal Angle ◽  
Follow Up Study ◽  
Chevron Osteotomy ◽  
Vas Scores ◽  
The Mean ◽  
American Orthopaedic

Abstract Purpose This study aimed to detect the effect of a modified chevron osteotomy on hallux valgus (HV) deformity at five-year follow up. Methods Twenty patients with symptomatic HV who underwent modified chevron osteotomy between June 2014 and January 2016 were included in the present study. The follow-up duration was more than five years. Each patient was evaluated preoperatively, six weeks postoperatively and five years postoperatively using the visual analog scale (VAS) pain score, the American Orthopaedic Foot & Ankle Society (AOFAS) score and cosmetic and radiological outcomes. Results The AOFAS score improved from 54.40 (± 4.58) preoperatively to 94.30 (± 2.15) six weeks postoperatively (p < 0.001) and 96.95 (± 1.54) five years postoperatively (p < 0.001). The VAS scores decreased from 6.30 (± 1.17)preoperatively to 0.15 (± 0.37) five years postoperatively (p < 0.001). The mean intermetatarsal angle improved from 16.00° (± 2.20°) preoperatively to 4.15° (± 1.22°) six weeks postoperatively (p < 0.001) and 4.40° (± 1.39°) five years postoperatively (p < 0.001). The mean HV angle also improved, from 32.70° (± 5.34°) preoperatively to 4.80° (± 1.40°) six weeks postoperatively (p < 0.001) and 5.20° (± 1.32°) five years postoperatively (p < 0.001). The cosmetic results were either excellent or good in 19 patients (95%). There was no recurrence in this study during the five postoperative years. Conclusion A modified chevron osteotomy can achieve successful correction of moderate-to-severe HV, with excellent outcomes at five-year follow up.

Ultrasound-Guided Platelet-Rich Plasma Injection in a Patient with a Plantar Fascia Tear

2017 ◽  
Vol 107 (6) ◽  
pp. 565-567 ◽  
Author(s):  
Gökhan Tuna Öztürk ◽  
Alper Murat Ulaşlı
Keyword(s):  
Female Patient ◽  
Platelet Rich Plasma ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Ultrasound Guided ◽  
Plasma Injection

We report the case of a 40-year-old female patient presenting with resistant heel pain attributable to plantar fascia rupture. She was treated with ultrasound-guided platelet-rich plasma injection, and her pain was decreased. Additionally, ultrasound was useful for diagnosis, intervention and follow-up of the patient.

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 Functional outcome of intra-articular tongue type of calcaneus fractures treated with percutaneous technique

2016 ◽  
Vol 2 (4) ◽  
pp. 371 ◽  
Author(s):  
Bhavik Y. Dalal ◽  
Raghav K. Suthar ◽  
Parag Y. Tank ◽  
Dipal Rathod ◽  
Harshal Damor
Keyword(s):  
Functional Outcome ◽  
Calcaneal Fracture ◽  
Percutaneous Technique ◽  
Percutaneous Fixation ◽  
Aofas Score ◽  
Radiological Criteria ◽  
Wound Healing Problems ◽  
American Orthopaedic ◽  
Calcaneus Fractures

<p><strong><span lang="EN-IN">Background: </span></strong><span lang="EN-IN">Intra-articular calcaneus fracture is relatively rare and morbidity correlates with displacement and relative alignment of fragments. The treatment should address both components to maintain mechanics of foot. Among the available options open reduction and internal fixation is associated with major soft tissue complications and wound healing problems. As an alternative percutaneous fixation offer fewer complications yet good results for less severe calcaneus fractures. Our study aimed to contribute paucity of data available for these rare fractures and help to propose a preferred method of treatment.</span></p><p class="abstract"><strong>Methods:</strong> A hospital based study carried out on 20 patients over period of 2 year with closed displaced intra-articular tongue type of calcaneal fracture treated with percutaneous fixation and outcome was evaluated using clinical, radiological criteria and American Orthopaedic Foot &amp; Ankle Society (AOFAS) score. All patients were followed up for minimum 9 months with mean follow up of 13.5 month.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients had evidence of union within 2 month follow up. Mean correction in Bohler angle and Gissane angle was 23.2° and 25.4° respectively at final follow up. Mean change in heel height was 3.15 mm and width change was 2.75 mm compare to opposite side. Mean eversion inversion arch was 28° and near normal ankle range of motion. Functional outcome calculated on bases of AOFAS score revealed 18 patients (90%) had good results and 2 patients (10%) had fair results. Mean AOFAS score was 81.25. Complications were reported in three patients, one had signs of peroneal tendinitis and two had persistent pain and heel widening<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions: </strong>We believe percutaneous fixation should be considered as a preferred method for mild to moderately displaced tongue type of intraarticular calcaneus fractures. It potentially allows anatomical fracture reduction with lesser complications and good functional outcome<span lang="EN-IN">.</span></p>

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.

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