title: Extensile decompression of the proximal and distal tarsal tunnel combined with partial plantar fascia release in the treatment of chronic plantar heel pain.
abstract: BACKGROUND
  Chronic heel pain that is recalcitrant to nonoperative measures is a rare but disabling condition. There are no reports in the literature of extensile proximal and distal tarsal tunnel release combined with partial plantar fasciotomy in the treatment of chronic heel pain. We present our results.
  
  
  METHODS
  A retrospective chart review was conducted, and charts were assessed for details of their presenting complaints, physical exam, diagnostic studies, medical history, Visual Analog Scale (VAS) scores for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores, and complications.
  
  
  RESULTS
  The mean AOFAS ankle-hindfoot score was 86 ± 12.9 (range = 69-100). Of 15 heels, 10 (67%) had an excellent or good rating at the time of the last follow-up visit. One of 15 (7%) reported a poor outcome. The mean VAS pain score changed from 6.3 ± 3.1 to 1.4 ± 1.8 (P = .001). There were no wound complications or infections.
  
  
  CONCLUSIONS
  This technique offers another operative option for chronic heel pain that is associated with satisfactory outcomes and rest pain relief. Despite reducing pain at rest in all patients, the majority of patients may be left with mild to moderate residual symptoms with activity that is similar to the outcomes of previously reported procedures.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina 27709, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Mook
authors.forename: Tenaja
authors.initials: T
authors.lastname: Gay
authors.forename: Selene G
authors.initials: SG
authors.lastname: Parekh
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000601:surgery*; D019299:Decompression, Surgical; D036981:Fasciitis, Plantar / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D013641:Tarsal Tunnel Syndrome / Q000601:surgery*; D013979:Tibial Nerve / Q000601:surgery*