In a prospective randomized study, we compared two different surgical techniques used in plantar fasciitis surgery.
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.
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%.
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.
Background: Distal osteotomy of the first metatarsal is a widely used method for the correction of mild-to-moderate hallux valgus deformities. The objective of this study was to compare the stability of headless compression screws, kirschner wires and absorbable pins in terms of stiffness and maximum load in distal oblique metatarsal osteotomy.
Methods: A total of 30 4th generation first metatarsal synthetic bone models were divided into three groups according to the fixation techniques. The stiffness of the first metatarsal was calculated as the slope of the linear curve that fit with the first linear part of the force displacement curve. The failure strength was recorded as the maximum load. The stiffness and maximum load values in the axillary and transverse configurations were compared between the three fixation groups.
Results: The stiffness was statistically higher in Group K and Group C compared to Group B in both axial and transverse loading. Similarly, the maximum load was significantly higher in both Group K and Group C compared to Group B in both loading conditions. No significant difference was found between Group K and Group C in stability. The higher failure strength was obtained with headless compression screws (113.34±35.88 N) in the axial loading. The lowest failure strength was found in the absorbable pins technique (16.17±7.72 N) in the transverse loading.
Conclusion: No significant difference was found between the Kirschner wires and headless compression screws techniques, although the highest strength was obtained with headless compression screws that are increasingly used in orthopedic practice.