Autologous blood injection and botulinum toxin for resistant plantar fasciitis accompanied by spasticity.
An originally ambulatory 18-yr-old woman with spastic left hemiplegic cerebral palsy developed left plantar fasciitis with a gradual loss of function requiring use of a wheelchair. Her symptoms were resistant to physical therapy. Two hundred units of botulinum toxin A was diluted in 4 mL of saline and injected into the gastrocnemius. Three milliliters of autologous blood was injected into the plantar fascia. She reported decreased pain at 3 days postinjection. At 10 days, she had no pain on walking. Dorsiflexion increased and Ashworth and Tardieu improved. A stretching program was taught and a better-fitting night splint was obtained. At 21 days, she exhibited no pain and increased dorsiflexion. Autologous blood injection combined with botulinum toxin A may be an alternative treatment for resistant plantar fasciitis accompanied by spasticity. Our hypothesis is that chronic plantar fasciitis is a degenerative condition and thus is relieved when a mild inflammatory process is created that leads to healing.
Logan
Lynne Romeiser
LR
Department of Physical Medicine and Rehabilitation, Upstate Medical University, Syracuse, New York 13210, USA.
Klamar
Karl
K
Leon
Jerry
J
Fedoriw
Wladislaw
W
D000293:Adolescent; D001804:Blood Transfusion, Autologous; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications; D003131:Combined Modality Therapy; D036981:Fasciitis, Plantar / Q000150:complications / Q000628:therapy*; D005260:Female; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D007273:Injections, Intramuscular; D009128:Muscle Spasticity / Q000150:complications / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010147:Pain Measurement; D013165:Splints
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A