Plantar fascia release through a transverse plantar incision.
A transverse plantar incision for plantar fascial release was assessed for pain relief, numbness, and subsequent heel pad symptoms. Twenty-seven feet in 26 patients who underwent plantar fascia release were reviewed with a minimum follow-up of 2 years after surgery (average, 37.6 months). Comprehensive data were obtained on 25 feet (24 patients) (93% response rate). The plantar fascia origin was completely transected in all cases. This led to complete resolution of symptoms in 19 feet and residual minor symptoms in six feet. After 2 years, four patients had developed recurrent symptoms, two in the area of surgery and two on the dorsum of the foot, in association with a pes planus foot. Two patients had some continued persistence of heel pain after surgery, although significantly less pain than preoperatively.Thus, 76% of patients had complete relieve of there symptoms, 12% of patients had mild symptoms not affecting daily activities, and 12% of patients had moderate symptoms that limited some activities. No patient suffered heel pad symptoms or numbness after surgery. It is concluded that plantar fascia release through a transverse plantar incision is a successful procedure for long-term relief of symptoms which avoids unnecessary heel pad numbness and scar morbidity. The benefits of a transverse incision include greater intraoperative vision, to ensure adequate release and spur excision, and an incision parallel to the medial calcaneal branches of the tibial nerve.
SPORTSMED.SA, Stepney, South Australia.
J N
JN
Brown
S
S
Roberts
M
M
Taylor
R S
RS
Paterson
D000328:Adult; D000368:Aged; D005096:Exostoses / Q000150:complications / Q000601:surgery; D005208:Fasciitis / Q000150:complications / Q000601:surgery* / Q000628:therapy; D000071938:Fasciotomy; D005260:Female; D005534:Foot Diseases / Q000150:complications / Q000601:surgery* / Q000628:therapy; D006365:Heel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods; D010146:Pain / Q000209:etiology; D016896:Treatment Outcome