• 1

    Thomas JL, Christensen JC, Kravitz S, et al: The diagnosis and treatment of heel pain. .J Foot Surg 40::329. ,2001. .

  • 2

    Vohra PK, Kincaid BR, Japour CJ, et al: Ultrasonic evaluation of plantar fascia bands: a retrospective study of 211 symptomatic feet. .JAPMA 92::444. ,2002. .

    • Search Google Scholar
    • Export Citation
  • 3

    Barrett BL, Day SV: Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical techniques-early clinical results. .J Foot Surg 30::568. ,1991. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Ward WG, Clippinger FW: Proximal medial longitudinal arch incision for plantar fascia release. .Foot Ankle 8::152. ,1987. .

  • 5

    Jacoby RP, Wolfe LC: Surgical management of recalcitrant heel pain. .Clin Podiatr Med Surg 8::187. ,1991. .

  • 6

    Kinley S, Fascone S, Calderone D, et al: Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study. .J Foot Ankle Surg 32::595. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Hill JJ, Cutting PJ: Heel pain and body weight. .Foot Ankle 9::254. ,1989. .

  • 8

    Braly WG: “Plantar Fascia Release,” in The Foot and Ankle, ed by KA Johnson, p 323, Raven Press, New York. ,1994. .

  • 9

    Schepsis AA, Leach RE, Gorzyca J: Plantar fasciitis: etiology, treatment, surgical results, and review of the literature. .Clin Orthop Rel Res 266::185. ,1991. .

    • Search Google Scholar
    • Export Citation
  • 10

    Schwartz NH: Inferior heel spur surgery. .Clin Podiatr Med Surg 7::261. ,1990. .

  • 11

    Intenzo CM, Wapner KL, Park CH, et al: Evaluation of plantar fasciitis by three-phase bone scinitigraphy. .Clin Nucl Med 16::325. ,1991. .

  • 12

    Kulthanan T: Operative treatment of plantar fasciitis. .J Med Assoc Thai 75::337. ,1992. .

  • 13

    Malay DS: “Heel Surgery,” in Comprehensive Textbook of Foot Surgery, 2nd Ed, Vol 1, ed by ED McGlamry, AS Banks, MS Downey, p 431, Williams and Wilkins, Baltimore. ,1987. .

  • 14

    Daly PJ, Kitaoka HB, Chao EY: Plantar fasciotomy for intractable plantar fasciitis: clinical results and biomechanical evaluation. .Foot Ankle 13::188. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Berkowitz JF, Kier R, Rudicel S: Plantar fasciitis: MR imaging. .Radiology 179::665. ,1991. .

  • 16

    Boike AM, Snyder AJ, Roberto PD, et al: Heel spur surgery: a transverse plantar approach. .JAPMA 83::39. ,1993. .

  • 17

    Self TC, Kunz RD, Young G: Transverse plantar incision for heel spur surgery. .JAPMA 83::259. ,1993. .

  • 18

    Barrett SL, Day SV, Brown MG: Endoscopic plantar fasciotomy: preliminary study with cadaveric specimens. .J Foot Surg 30::170. ,1991. .

  • 19

    Japour CJ, Vohra P, Garfunkel L, et al: Management of heel pain syndrome with acetic acid iontophoresis. .JAPMA 89::251. ,1999. .

  • 20

    Campbell JW, Inman VT: Treatment of plantar fasciitis and calcaneal spurs with the UC-BL shoe insert. .Clin Orthop 103::57. ,1974. .

  • 21

    Chang CC, Miltner LJ: Periostitis of the os calcis. .J Bone Joint Surg 16::355. ,1934. .

  • 22

    Furey JG: Plantar fasciitis: the painful heel syndrome. .J Bone Joint Surg Am 57::672. ,1975. .

  • 23

    Amis J, Jennings L, Graham D: Painful heel syndrome: radiographic and treatment assessment. .Foot Ankle 9::91. ,1988. .

  • 24

    Kenzora JE: The painful heel syndrome: an entrapment neuropathy. .Bull Hosp Jt Dis Orthop Inst 47::178. ,1987. .

  • 25

    Lapidus PW, Guidotti, FP: Painful heel: report of 323 patients with 364 painful heels. .Clin Orthop 39::178. ,1965. .

  • 26

    O’Brien D, Martin WJ: A retrospective analysis of heel pain. .JAPMA 75::416. ,1985. .

  • 27

    Shikoff MD, Figura MA, Postar SE: A retrospective study of 195 patients with heel pain. .JAPMA 76::71. ,1986. .

  • 28

    Snook GA, Chrisman OD: The management of subcalcaneal pain. .Clin Orthop 82::163. ,1972. .

  • 29

    Lutter LD: Surgical decisions in athletes’ subcalcaneal pain. .Am J Sports Med 14::481. ,1986. .

  • 30

    Lee GP, Ogden JA, Cross GL: Effect of extracorporeal shock waves on calcaneal bone spurs. .Foot Ankle Int 24::927. ,2003. .

  • 31

    Hyer CF, Vancourt R, Block A: Evaluation of ultrasound guided extracorporeal shock wave therapy (ESWT) in the treatment of chronic plantar fasciitis. .J Foot Ankle Surgery 44::137. ,2005. .

    • Search Google Scholar
    • Export Citation
  • 32

    DuVries HL: Heel spur (calcaneal spur). .AMA Arch Surg 74::536. ,1957. .

  • 33

    Gormley J, Kuwada GT: Retrospective analysis of calcaneal spur removal and complete facial release for the chronic treatment of heel pain. .J Foot Surg 31::166. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Lewis G, Gatti A, Barry LD: The plantar approach to heel spur surgery: a retrospective study. .J Foot Surg 30::542. ,1991. .

  • 35

    Ali E: Calcaneal spur. .West Indian Med J 29::175. ,1980. .

  • 36

    Contompasis JP: Surgical treatment of calcaneal spurs: a three-year post-surgical study. .JAPA 64::987. ,1974. .

  • 37

    Vohra PK, Giorgini RJ, Sobel E, et al: Long-term follow-up of heel spur surgery: a 10 year retrospective study. .JAPMA 89::81. ,1999. .

  • 38

    US Public Health Service: Healthy People 2000: National Health Promotion and Disease Prevention Objectives, DHHS Publication PH591-50212, US Government Printing Office, Washington, DC. ,1990. .

  • 39

    Tasso JP, Cummings J, Eves WC, et al: Treatment of chronic tendonosis with bipolar radiofrequency stimulation. Presented at the Arthroscopy Association of North America Annual Meeting, April 2003, Phoenix, AZ..

    • Crossref
    • Export Citation
  • 40

    Kitaoka HB: Salvage of nonunion following ankle arthrodesis of a failed total ankle arthroplasty. .Clin Orthop 268::37. ,1991. .

  • 41

    Sharp RJ, Wade CM, Hennessy MS, et al: The role of MRI and ultrasound imaging in Morton’s neuroma and the effect of size of lesion on symptoms. .J Bone Joint Surg 85B::999. ,2003. .

    • Search Google Scholar
    • Export Citation
  • 42

    Gerlung MC, Pfirrmann CA, Farooki S, et al: Comparison of the diagnostic efficacy of magnetic resonance imaging and ultrasonography for the detection of surgically created longitudinal tears in cadavers. .Investigative Radiol 38::51. ,2003. .

    • Search Google Scholar
    • Export Citation
  • 43

    Wall JR, Harkness MA, Crawford A: Ultrasound diagnosis of plantar fasciitis. .Foot Ankle Int 14::465. ,1993. .

  • 44

    Cardinal E, Cjeri RK, Beauregard CG, et al: Plantar-fasciitis sonographic evalution. .Radiology 201::257. ,1996. .

  • 45

    Lester DK, Buchanan JR: Surgical treatment of plantar fasciitis. .Clin Orthop 186::202. ,1984. .

  • 46

    Baxter DE, Thigpen CM: Heel pain: operative results. .Foot Ankle 5::16. ,1984. .

  • 47

    Leach RE, Seavey MS, Salter DK: Results of surgery in athletes with plantar fasciitis. .Foot Ankle 7::156. ,1986. .

  • 48

    Snider MP, Clancy WG, McBeath AA: Plantarfascia release for chronic plantar fasciitis in runners. .Am J Sports Med 11::215. ,1983. .

  • 49

    Barrett SL, Day SV: Endoscopic plantar fasciotomy: two portal endoscopic technique: clinical results of 65 procedures. .J Foot Surg 32::248. ,1993. .

    • Search Google Scholar
    • Export Citation
  • 50

    Jerosch J, Schunck J, Liebsch D, et al: Indications, surgical technique and results of endoscopic fascial release in plantar fasciitis (EFRPF). .Knee Surg Sports Traumatol Arthrosc 12::471. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation

Ultrasound-guided Plantar Fascia Release Technique

A Retrospective Study of 46 Feet

Praveen K. Vohra Private practice, Plainfield, IL.

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Christopher J. Japour Department of Surgery, Northport Veterans Affairs Medical Center, Northport, NY.

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Background: Ultrasound-guided plantar fascia release offers the surgeon clear visualization of anatomy at the surgical site. This technique uses small arthroscopic dissecting instruments through a 0.5-cm incision, allowing the surgeon to avoid the larger and more tissue-disruptive incision that is traditionally used for plantar heel spur resection and plantar fascia releases.

Methods: Forty-one patients (46 feet) were selected for the study. The mean patient age was 47 years. Twenty-nine were considered obese with a body mass index greater than 30 kg/m2. Patients were functionally and subjectively evaluated 4 weeks after surgery using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Rating Scale.

Results: Results from the study show a significant improvement (P = .05 confidence level) 4 weeks postoperatively for the 41 patients (46 feet), compared to their preoperative condition. The mean pretest score was 33.6 (range 10–52); this score improved to 88.0 (range 50–100), 4 weeks postoperatively. There were no postoperative infections or complications.

Conclusions: The ultrasound-guided plantar fascia release technique is a practical surgical procedure for the relief of chronic plantar fascia pain because the surgeon is able to clearly visualize the plantar fascia by ultrasound. In addition, there is minimal disruption to surrounding tissue because small instruments are passed through a small 0.5-cm incision. The traditional open method of heel spur surgery, in contrast, uses a larger skin incision of 3 to 5 cm, followed by larger instruments to dissect to the plantar fascia. (J Am Podiatr Med Assoc 99(3): 183–190, 2009)

Corresponding author: Christopher J. Japour, DPM, MS, Department of Surgery, Northport Veterans Affairs Medical Center, 79 Middleville Rd, Northport, NY 11738. (E-mail: christopher.japour@va.gov)