Abstract
The purpose of this study was to assess the effectiveness of a new procedure, ultrasound-guided partial plantar fasciotomy with needle for plantar fasciosis. Methods: This study was carried out on 16 patients, 9 men and 7 women, with average age 47.5, diagnosed with plantar fasciosis, who were treated through ultrasound-guided partial plantar fasciotomy using multiple perforations. Clinical assessments and ultrasounds of all patients were carried out before treatment, after a week, then after 1, 3 and 12 months. For the clinical assessment the Visual Analogue Scale (VAS) and the Foot and Ankle Disability Index (FADI) were used. Results: There was significant progress at 95% (Greenhouse-Geisser p < 0.001) of the VAS and the FADI during the study. We had no nerve or other complications: paraesthesia of the entry portal or vascular lesions. Conclusion: Ultrasound- guided partial plantar fasciotomy using multiple perforations is a safe technique, with very satisfactory preliminary results, reducing recovery times and time off work. The technique can be performed in the specialist’s consultation room with local anaesthesia, without the need for stitches and with very fast recovery, thus reducing costs. It can be performed on patients with underlying pathology such as diabetes mild to moderate, vascular insufficiency, heart disease or other comorbidities, so this technique could be an improvement on other open plantar fasciotomy surgical techniques.
Highlights
Plantar fasciitis is the most common cause of lower heel pain
It is believed that biomechanical changes or repeated traumas favour a mechanical overload which can cause microscopic tears of the fascia and an initial inflammatory process which, in the final phases, leads to fibrosis and myxoid degeneration of the collagen tissue, with angiofibrotic hyperplasia, meaning that the more correct term would be plantar fasciosis, rather than plantar fasciitis [6] [7]
We have presented the advancement in this technique performed without tourniquet, with 1 - 2 mm incisions, with local anaesthesia, as an outpatient procedure
Summary
Plantar fasciitis is the most common cause of lower heel pain. It is estimated that 10% of the population at someHow to cite this paper: Iborra, A., Villanueva, M.J. and Barrett, S.L. (2016) Ultrasound-Guided Plantar Fascia Release with Needle: A Novel Surgical Technique. Plantar fasciitis is the most common cause of lower heel pain. A study carried out in the USA between 1995 and 2000 found that approximately one million medical appointments were due to pain in the plantar fascia [2]. The incidence of plantar fasciitis is greater among people aged between 40 and 60, with predominance 2:1 female to male, it is common in the athlete population [3]-[5]. It is believed that biomechanical changes or repeated traumas favour a mechanical overload which can cause microscopic tears of the fascia and an initial inflammatory process which, in the final phases, leads to fibrosis and myxoid degeneration of the collagen tissue, with angiofibrotic hyperplasia, meaning that the more correct term would be plantar fasciosis, rather than plantar fasciitis [6] [7]
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