title: Distal tarsal tunnel release with partial plantar fasciotomy for chronic heel pain: an outcome analysis.
abstract: This study evaluated the effectiveness of distal tarsal tunnel release with a partial plantar fasciotomy for chronic subcalcaneal pain syndrome in patients who failed nonoperative management through a retrospective review of all patients undergoing this procedure between 1994 and 1999. Distal tarsal tunnel release and a partial plantar fasciotomy were offered only to those patients with disabling heel pain and were performed under general anesthesia or ankle block. Seventy-five patients (80 heels), averaging 20 months of nonoperative treatment, were identified (group I). Postoperative outcome questionnaires (SF-36 and Foot Function Index [FFI]) were sent to these patients and 44 (46 heels) responded (group II). In group I, 88% of patients had a good to excellent result. Many continued with mild to moderate residual symptoms, which typically did not limit their activity. In group II, 91% of patients were somewhat to very satisfied with their outcome. Visual analogue scale scores for pain were reduced by a mean of 55. SF-36 scores, matched against a control group of patients receiving just nonoperative treatment, showed a statistically significant improvement in all pain and functioning subcategories. We conclude that a distal tarsal tunnel release with a partial plantar fasciotomy may successfully increase function and decrease pain in patients who fail nonoperative treatment.
authors.affiliation: Desert Orthopaedic Clinic, Las Vegas, NV 89128, USA.
authors.forename: Troy S
authors.initials: TS
authors.lastname: Watson
authors.forename: Robert B
authors.initials: RB
authors.lastname: Anderson
authors.forename: W Hodges
authors.initials: WH
authors.lastname: Davis
authors.forename: Gary M
authors.initials: GM
authors.lastname: Kiebzak
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy; D000071938:Fasciotomy; D005260:Female; D005528:Foot / Q000601:surgery*; D005529:Foot Bones / Q000601:surgery*; D006365:Heel; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome