Comparison of clinical efficacy of proximal medial gastrocnemius release and shock wave for treating unilateral chronic plantar fasciitis

Abstract

Objective To explore the validity of proximal medial gastrocnemius release (PMGR) for treating unilateral chronic plantar fasciitis. Methods The prospective study was conducted. From January 2018 to July 2018, 56 patients who were diagnosed chronic plantar fasciitis in Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, were enrolled and divided into study group(n=28) and control group(n=28) according to different therapies. Fifty-six patients were enrolled including 33 males and 23 females, the age was (48.1±6.2) years (range, 43.9-57.1 years). The patients in study group were treated with PMGR for unilateral chronic plantar fasciitis. Meanwhile, the patients in control group were treated by shock wave therapy, one extracorporeal shock wave therapy was accepted every 3 days, each impact 2 000 times, a total of five times. Visual analogue scale(VAS), the American orthopaedic foot and ankle hindfoot scale (AOFAS) and dorsal extension range of ankle joint of all patients before treatment and 3 months after treatment were recorded and compared. All the patients were outpatient followed for (3.9±0.7) months until October 2018, the pain and function of feet were recorded. Measurement data with normal distribution were expressed as mean±standard deviation (Mean±SD). The data were statistically analyzed by t test between two groups.Count data were analyzed by chi-square test between two groups. Results In study group, preoperative VAS, AOFAS and dorsal extension angleof ankle joint were (6.9±0.8) scores, (48.4±2.8) scores and (10.8±3.9)°, while 3 months after treatment VAS, AOFAS and dorsal extension angleof ankle joint were (2.1±1.0) scores, (82.8±3.6) scores and (21.9±4.8)°. The difference between pre-operation and 3 months after treatment of study group was significant(P 0.05). At 3 months after treatment, there were significant differences in VAS, AOFAS and dorsal extension angle of ankle joint between two groups(P<0.05), and the outcome of study group was better than the control group. Conclusions PMGR can not only relief pain of foot but also improve ankle function. This is an effective surgical treatment for unilateral chronic plantar fasciitis. Key words: Metatarsus; Fasciitis; High-energy shock waves; Gastrocnemius