Heel Spur Research Articles

The Prevalence and Risk Factors of Plantar Fasciitis Amongst the Population of Jazan.

BackgroundPlantar fasciitis develops as a consequence of irritation of the plantar fascia, which is responsible for supporting the arches and absorbing shock. Multiple factors can contribute to plantar fasciitis, but the most common factor is overuse stress. The classical presentation is a sharp pain that is felt at the plantar aponeurosis (near the area of its insertion on the medial process of the calcaneal tuberosity), and it is possible to find a heel spur (osteophyte) in some cases. Most treatments for plantar fasciitis are ineffective and unsatisfactory for patients.ObjectiveTo estimate the prevalence and assess risk factors for plantar fasciitis among the population of the Jazan region.MethodsA cross-sectional online survey was conducted on the population of the Jazan region. An online Google form questionnaire was prepared and distributed to the study population. Data was then entered and analyzed using IBM SPSS (Statistical Package for the Social Sciences) Statistics, version 21.0.ResultsA total of 695 participants were enrolled in the study. Out of that, 350 (50.4%) of the participants were males, while 345 (49.6%) were females. About the age of the participants, 507 (72.9%) were younger than 40 years of age. Participants with hypertension were 43 (6.2%), and 37 (5.3%) participants had diabetes. In terms of occupation, 120 (17.3%) worked in healthcare, 187 (26.9%) taught, and 43 (6.2%) served in the military. A great quantity of standing or walking was necessary for the jobs for 127 people (18.3%), while moderate amounts were recorded for 273 people (39.3%). The most commonly reported lower limb conditions were: pes planus (low arches) in 26 (3.7%) participants; and weakness of the gastrocnemius, soleus, and intrinsic foot muscles. The most commonly reported exercises were walking for 499 (71.8%) participants and jogging for 97 (14%) participants. The prevalence of plantar fasciitis was found to be 37% of the participants. Regarding the Foot and Ankle Outcome Score (FAOS) survey, the mean symptoms subscale score was 57.81 + 11.28, the mean pain subscale score was 72.87±20.84, the mean daily living subscale score was 72.73 ± 22.25, the mean sports and recreation subscale score was 76.83 ± 23.06, and the mean quality of life subscale score was 70.23 ± 25.17. Multivariate logistic regression was done and the following factors predicted a higher rate of plantar fasciitis: being 40 to 55 years old (p < 0.001, odds ratio = 2.15), being 56 to 65 years old (p = 0.037, odds ratio = 3.58), being obese (p = 0.031, odds ratio = 2.16), having weakness of the gastrocnemius, soleus, and the intrinsic foot muscles (p = 0.003, odds ratio = 7.39), jobs requiring a great amount of time standing or walking (p < 0.001, odds ratio = 3.17), and jobs requiring a moderate amount of time standing or walking (p = 0.012, odds ratio = 1.83). Being male predicted a lower rate of plantar fasciitis (p < 0.001, odds ratio = 0.52).ConclusionPlantar fasciitis is a prevalent and disabling condition with considerable effects on quality of life. Jobs that require long hours of walking or standing were associated with an increased risk of developing plantar fasciitis. Middle age, prolonged exercise, and gastrocnemius muscle tightness were also associated with plantar fasciitis. Efforts should be directed towards health education of the population regarding the risk factors and management of plantar fasciitis.

Effectiveness of stretching exercises in conservative therapy of plantar fasciitis (PF)

Introduction and objective: Plantar fasciitis affects both young active patients and older people leading a sedentary lifestyle. It is result from chronic overload of the plantar fascia. About 80% of patients with plantar fasciitis improve within 12 months with non-surgical treatment. Nonsurgical management includes e.g. activity modification, cooling, non-steroidal anti-inflammatory drugs, stretching and strengthening exercises and manual therapy. Materials and methods: PubMed database was searched. The criteria for qualifying the articles for the review were the following keywords: plantar fasciitis, muscle stretching, exercise, manual therapy, heel spur. 11 articles from 2017 to 2022 were analyzed. Description of the state of knowledge: Calf stretching is one of the treatments for plantar fasciitis with the best results in the long run. In turn, strengthening exercises turn out to be more effective in a short time. One should also not forget about influence other methods of conservative treatment, such as cooling, orthoses or physical therapy, that support and accelerate the treatment process. Summary: Strengthening exercises of the plantar fascia are more effective than stretching in terms of reducing pain and improving function in the short term, while stretching exercises show better results in the long term. The best results are obtained by combining stretching of the triceps calf muscle with other methods of conservative treatment. There are no studies supporting the hypothesis that stretching alone is more effective in the treatment process than other methods and placebo.

Endoscopic Plantar Fascia Release Combined With Calcaneal Spur Resection: A Case Series of 40 Patients.

To review the cases of patients treated using endoscopic plantar fascia release (PFR) with calcaneal spur resection (CSR) and examine why the combined procedures cause complications. The medical records of patients treated with endoscopic PFR with CSR from November 2017 to December 2019 with a follow-up of >2 years were reviewed. A total of 40 feet in 40 patients (22 females, 18 males) were enrolled. The mean age and body mass index were 51.1 years and 24.7 kg/m2, respectively. The mean follow-up duration was 5.7 years. The visual analog scale for pain improved from 80.7 to 8.8 mm, and the Japanese Society for Surgery of the Foot score improved from 44.7 to 95.6 points (Wilcoxon signed rank test, P < .001 for both). Complications occurred in 8 patients (20%): 3 had flatfoot, 3 had an injury to the first branch of the lateral plantar nerve, 1 had scar pain, and 1 had a wound infection. The 40 patients treated with endoscopic PFR with CSR for plantar fasciitis had good outcomes with a high complication rate; the invasiveness of creating the working space for the combined procedures was thought to be responsible. Level IV: Case series.

Plantar Fasciopathy - Pathophysiology Diagnostics and Therapy - A Clinical Guideline

Plantar Fasciopathy - Pathophysiology Diagnostics and Therapy - A Clinical Guideline Abstract. Plantar fasciitis (often referred to as "heel spurs") is a common problem in daily practice. Approximately 4-10% of the general population is affected, in athletes the prevalence is even higher with an estimated prevalence of 5-18%. Heel pain is one of the most common running injuries. Besides runners, overweight individuals exposed to several hours of standing or walking daily are also at risk. The reduction in quality of life can be considerably high. The diagnosis can usually be secured by means of a targeted anamnesis and clinical examination, backed up by ultrasound examination or MRI. The most common differential diagnoses are irritation of the Baxter's nerve, tarsal tunnel syndrome, and insertional tendinopathy of the Achilles tendon. Plantar heel pain is a domain of conservative therapy, surgical procedures are very rarely required. The basic therapy consists of patient education and stretching exercises, it can be expanded by low dye taping, insoles, and extracorporeal shock wave therapy. If this does not lead to a significant improvement in symptoms, night splints and infiltrations can be useful.

Calcaneal Spurs: A Potentially Debilitating Disorder.

Feet are often the most neglected part of the body, all the while being the highly dependent part of daily work and mobility. The lack of attention to them can lead to painful conditions such as calcaneal spurs and associated conditions. Calcaneal spurs are bony projections that form around the calcaneal bone, the strongest, most significant, and posterior-most bone in the feet. The classic symptom of the calcaneal spur is talalgia, commonly known as heel pain. There are many causes of heel pain, which are usually associated with calcaneal spurs. Hence it becomes imperative to diagnose and treat them effectively. The development of calcaneal spur is shrouded in mystery, and why a few individuals are more prone to developing the condition than others depends on their gender, age, occupation, and lifestyle. Calcaneal spurs are seen in association with many diseases. It is also regarded as the etiological factor in plantar fasciitis and increasing body weight and as a complication in arthropathies, Gout, pes cavus, and pes planus. This review article aims to highlight a relationship between those factors while also summarizing the treatment modalities present today. Hence, it promotes the usage of a model for administering treatment based on a tier-wise follow-up procedure, where the response to a particular treatment is recorded. If it does not resolve the spur, the treatment progresses to the next tier. This review article hopes to shed light on the understanding and treatment of calcaneal spurs.

Effectiveness of mechanical treatment with customized insole and minimalist flexible footwear for women with calcaneal spur: randomized controlled trial

BackroundCalcaneal spurs are described as bony outgrowths arising on medial calcaneal, where inappropriate footwear can promote disease progression.ObjectiveInvestigate the effectiveness of mechanical treatment with customized insole and minimalist flexible footwear during gait training program in women with calcaneal spur.MethodsDesign: A single-blinded, randomized and controlled trial. Setting: Biomechanics laboratory. Participants: Forty-three women, 29 with calcaneal spur and 14 control.InterventionGait training program with use of the minimalist flexible footwear (MFG n = 15, age: 48.9 ± 9.4, height: 1.61 ± 0.1, BMI: 32.1 ± 7.0) and customized insole on footwear (COIG n = 14, age: 50.3 ± 5.8, height: 1.62 ± 0.1, BMI: 32.2 ± 4.3) and control (CG n = 14, age: 47.8 ± 8.6, height: 1.63 ± 0.1, BMI: 27.5 ± 4.5), followed of the evaluations: baseline (T0) and after three (T3) and six (T6) months. Duration of the intervention was of the six months consecutive for at least 42 h per week (six hours a day, seven days a week). Outcome primary were calcaneus pain (visual analogue scale), Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br) and 6-min walk test (6MWT). Secondary was plantar pressure distribution by a pressure platform system during gait and static index foot posture (FPI). Statistical analysis: analysis of variance for repeated measure and between groups were used to detect treatment-time interactions (α = 5%). Effect size with D Cohen’s also was used between T0 and after six (T6) months of intervention.ResultsThe MFG and COIG were effective at reducing pain after six months (MFG: 2.5–4.5 CI, p = 0.001; COIG: 1.5–3.5 CI, p = 0.011). The FFI and FHSQ-Br showed improvements with MFG and COIG after T6 (MFG: 13.7–15.4 CI, p = 0.010; COIG: 11.3–15.0 CI, p = 0.001). The 6MWT increased with MFG (589.3–622.7 CI) and COIG (401.3–644.7 CI) and foot pronation was decreased after T3 and T6 MFG (FPI Right: 4.2–5.4 CI; Left: 3.6–5.4 CI) COIG (FPI Right: 3.4–6.8 CI; Left: 3.3–5.7 CI). The contact area reduced on forefoot and rearfoot with MFG and GOIG and midfoot and rearfoot with MFG. Maximum force was reduced on foot with MFG after T3 and T6. The peak pressure was reduced on the forefoot with MFG and COIG and on midfoot and rearfoot with MFG.ConclusionsThe mechanical treatment with customized insole and minimalist flexible footwear during gait training program during six months in women with calcaneal spur reduced the calcaneus pain, increased function and health feet and reduced plantar load on the rearfoot, midfoot and forefoot. However, the footwear alone was more effective than when combined customized insole, given the greater efficacy on clinical and biomechanical aspects.Trial registrationClinicalTrials.gov NCT03040557 (date of first registration: 02/02/2017).

Quality and readability of online information on plantar fasciitis and calcaneal spur.

Plantar fasciitis and calcaneal spur are common causes of heel pain in the community. People use the Internet to obtain medical information about diseases. We reviewed Internet information sources on plantar fasciitis and calcaneal spur for quality and readability. The first 50 websites for each search term ("calcaneal spur", "heel spur", and "plantar fasciitis") were scanned on www.google.com . Six different valid tools were used for information quality and readability assessment. We searched for HONCode (Health On the Net Foundation Code) stamps on included websites. The total mean points for DISCERN were 50.52 ± 14.62, and the total mean points for JAMA (Journal of the American Medical Association) were 2.42 ± 1.26. In total, 25.72% of 97 websites had HONCode stamps. The average scores for the readability indicators were calculated to be Flesch-Kincaid Grade Level (FKGL): 7.27 ± 1.71, Gunning Fog: 8.46 ± 2.17, Simple Measure of Gobbledygook (SMOG): 6.89 ± 1.24, and Coleman Liau Index: 15.56 ± 1.85. In our study, when the website resources were examined, there were profit websites the most and website quality and readability were moderate level. A significant proportion of the websites have a financial bias and provide low-quality information. A mechanism for monitoring the quality and readability of online information must be established and managed systematically.

Comparison between radial and focused types of extracorporeal shock-wave therapy in plantar calcaneal spur: A randomized sham-controlled trial

ABSTRACT Objectives Both radial and focused types of extracorporeal shock wave therapy (ESWT) have been used in patients with plantar calcaneal spur (PCS). However, no study has yet addressed the comparative effects of these treatments on the condition. Considering radial and focused waves are different from each other, their effectiveness may also be different in clinical practice. The aim of this study was to compare the effects of radial and focused types of ESWT on PCS. Methods Ninety-nine patients with plantar calcaneal spur were randomised into three groups according to ESWT types: focused, radial, and sham. ESWT was applied as three sessions, with 2–4 days intervals (excluding weekends). All patients were evaluated at baseline (week 0) and weeks 1, 5, and 13. The Foot Function Index (FFI) scores were used as outcome measures. Results Compared with baseline (week 0), at the end of treatment (week 1) and at the follow-up periods (weeks 5, and 13) the FFI scores were significantly reduced in both focused and radial ESWT groups (for all, p < 0.001). When considering the change in data from baseline to follow-up periods (weeks 5, and 13), both focused and radial ESWT groups were significantly superior to the sham group in the all outcome measures (for all, p < 0.05). Importantly, the radial group was significantly superior to focused group based on the changes in the FFI scores (for all, p < 0.05). Conclusion Both focused ESWT and radial ESWT are effective in plantar calcaneal spur. When considering the degree and continuity of the positive effects, radial ESWT is superior to focused ESWT in plantar calcaneal spur.

Low-level laser therapy versus extracorporeal shock wave therapy in calcaneal spur.

Low-level laser therapy versus extracorporeal shock wave therapy in calcaneal spur.

The co-occurrence of calcaneal spur and hallux valgus: A radiological evaluation.

Calcaneal spur and hallux valgus are common foot deformities and both conditions have been shown to disrupt foot biomechanics. This study aimed to investigate the association between calcaneal spur and hallux valgus using radiographic and demographic data. A total of 1375 patients (1083 women; mean age: 45.5years) with standard ankle lateral and foot conventional anteroposterior radiographs were evaluated. The following data were obtained: age, gender, laterality, hallux valgus angle (HVA), intermetatarsal angle (IMA), and calcaneal spur. Patients with a HVA of 15∘ and above were considered to have hallux valgus. Patients with hallux valgus were classified into three different groups according to the HVA. The prevalence of calcaneal spur was higher in older age and women (45.8%, 30.2%; p< 0.01, p< 0.01, respectively). Subjects with and without calcaneal spurs had similarities in terms of their laterality, having a HVA of ⩾ 15∘ and an IMA of ⩾ 11∘ (p> 0.05). Hallux valgus severity was not associated with calcaneal spur (p> 0.05). In addition, the hallux valgus prevalence was higher in patients who were over 50years old (58.2%, p= 0.046). The presence of calcaneal spurs does not affect the prevalence of hallux valgus. The severity of hallux valgus determined according to the HVA was similar in patients with and without calcaneal spurs. In addition, female gender and older age were identified as risk factors for calcaneal spurs, while only older age was a risk factor for hallux valgus.

A retrospective magnetic resonance imaging analysis of bone and soft tissue changes associated with the spectrum of tarsal coalitions.

We aimed to investigate the bone and soft tissue changes accompanying tarsal coalition (TC) and aimed to evaluate their association with the location and type of coalition. Ankle magnetic resonance imagings of 65 patients with TC were included. The relationship between the location and type of coalition and bone marrow edema, subchondral cysts, sinus tarsi syndrome, tarsal tunnel syndrome, posterior impingement syndrome, accessory bone, tibiotalar effusion, talar osteochondritis dissecans, ganglion cysts, and calcaneal spur were evaluated. Twenty-nine patients without coalition were selected as the control group, and the distribution of these variables between the two groups was analyzed. There were 33 females and 32 males in the coalition group (mean age: 42.0 ± 15.63 years), and 22 females and seven males in the control group (mean age: 44.79 ± 12.33 years). Coalition was most common in the talocalcaneal joint (n=33, 50.8%), and the most common coalition type was non-osseous (n=57, 87.6%). We find no significant difference between the pathologies defined in terms of coalition location and type. Sinus tarsi syndrome, tarsal tunnel syndrome, subchondral cysts, and tibiotalar effusion were found to be more common in the coalition group (p=0.028, p=0.010, p=0.023, and p=0.006, respectively). The presence of coalition increased the probability of developing tarsal tunnel syndrome 9.91 times (95% CI: [1.25-78.59]; p=0.029), and sinus tarsi syndrome 3.66 times (95% CI: [1.14-11.78]; p=0.029). Tarsal coalition may predispose bone and soft tissue changes. In this study, sinus tarsi syndrome, tarsal tunnel syndrome, subchondral cysts and tibiotalar effusion were found to be more common in the coalition group.

Fluoroscopic and Endoscopic Calcaneal Spur Resection Without Plantar Fascial Release for Recalcitrant Plantar Fasciitis.

Background:Studies on endoscopic calcaneal spur resection (CSR) without plantar fascial release (PFR) are limited. This study aimed to review the data of patients who underwent fluoroscopic and endoscopic CSR without PFR for plantar fasciitis with a calcaneal spur to assess the effectiveness of CSR.Methods:Medical records of consecutive patients with plantar fasciitis with ≥2 mm calcaneal spur who underwent endoscopic CSR without PFR from November 2017 to December 2019 were reviewed. Patients with ≥2 years of follow-up were included, whereas those who underwent another surgery on the operated foot were excluded. Age, body mass index (BMI), follow-up duration, calcaneal spur length, duration to full weightbearing postoperatively, Japanese Society for Surgery of the Foot (JSSF) score, visual analog scale (VAS) score for pain, and complications were assessed.Results:The mean follow-up duration was 2.7 years. A total of 47 patients (31 female, 16 male; mean age, 56.4 years; mean BMI, 25.5) were included. The mean calcaneal spur length was 5.7 mm. The VAS score improved from 79.6 ± 12.9 mm preoperatively to 5.3 ± 7.3 mm postoperatively. The JSSF score improved from 54.0 ± 19.1 points preoperatively to 97.5 ± 5.7 points postoperatively (Wilcoxon signed-rank test, P < .001, respectively). The mean duration to full weightbearing postoperatively was 4.4 ± 4.2 days. Two patients presented with tenderness, and one presented with hypesthesia at the portal site.Conclusion:Endoscopic CSR without PFR resulted in good outcomes, early return to full weightbearing, and few complications in patients with plantar fasciitis with ≥2 mm calcaneal spur. The results suggested that CSR was sufficient to relieve symtoms and improve function. PFR may not be necessary for treating plantar fasciitis with calcaneal spur.Level of Evidence:Level IV, retrospective case series.

Painful calcaneal spur often misdiagnosed for lumbar radicular pain

Background: Persistence of painful calcaneal spur (PCS) and loss of long-term effect may be related to unrecognized low back pain (LBP), dysfunction and/or lumbosacral radiculopathy (LSR), but prevalence of LBP in PCS patients has not been established. Purpose: to determine the prevalence of LBP among individuals with and without PCS. Methods: A cross-sectional study of individuals with (n = 26) and without (n=27) PCS. X-ray used to determine calcaneal spur. MRI and X-ray (as available), and clinical tests used to determine LBP/pathology/LSR. Results: A greater percentage of individuals with PCS had LBP (88.5% vs. 33% in controls), lumbar pathology (58 vs. 19), and LSR (54 vs. 15). Conclusion: Individuals with painful calcaneal spur had a greater prevalence of LBP/lumbar pathology/LSR. Treatment to address impairments related to lumbar spine may be necessary to enhance the treatment of PCS.

Prevalence of Heel Spur In Teachers

Calcaneal heel spur is a typical foot problem that impairs 15–20% of the community and can affect people of all ages. Heelspur cause pain during walking and prolong standing. Calcaneal spurs' pathogenesis is poorly known. Heel spurs are found in around half of all individuals with plantar fasciitis. Methods: A cross-sectional investigation was carried out among 141 (both genders) participants mainly teachers by profession from the different hospitals of Lahore. Research was done in order to determine the incidence of heel spur in teachers. Data was collected by questionnaire and checking their radiographs. Descriptive analysis using SPSS version 26.0 to find results. Results: Overall prevalence came out as 79 (56%) teachers indicate heel spurs and 62 (44%) indicate no heel spur. Conclusion: The finding of this study showed that prolong standing can be the cause of foot pain and cause changes. Participants indicate foot pain due to heel spurs.

The levels of 25-hydroxy vitamin D, parathyroid hormone, calcitonin and lipid profiles in patients with calcaneal spur.

Objectives The aim of this study was to investigate the 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and calcitonin levels and lipid profiles in patients with calcaneal spurs. Patients and methods Between March 2018 and June 2019, a total of 50 patients (30 males, 20 females; mean age: 39.8±8.1 years; range, 24 to 54 years) admitted to our clinic with heel pain and diagnosed with heel spurs based on radiographic images were included. The control group consisted of 50 age- and sex-matched healthy volunteers (32 males, 18 females; mean age: 35.7±9.6 years; range, 20 to 56 years). Blood samples were collected from all participants. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, phosphate, and calcium levels were measured using the colorimetric method. The PTH and 25(OH)D levels were measured using the chemiluminescent microparticle immunoassay. Calcitonin levels were detected using the chemiluminescent immunometric assay. Results In the patients with calcaneal spurs, 25(OH)D and HDL-C levels were significantly lower (p<0.001), while LDL-C, triglyceride, and PTH levels were significantly higher (p<0.05, p<0.002 and p<0.001, respectively). There was no significant difference in the calcium, phosphate, body mass index, and calcitonin levels between the groups. Conclusion Our study results suggest that calcaneal spur formation is associated not only with weight-related pressure, but also with lipid levels and hormonal alterations involved in calcium metabolism. Based on these findings, hormonal alterations and lipids should be considered in patients with calcaneal spurs.

Differentialdiagnose dorsaler Fersenschmerz

Heel pain is a common complaint with a prevalence of 15%. Besides inflammatory, infectious, neuropathic or tumor associated causes of pain, a mechanical bony or soft-tissue related disorder can be identified in most cases. Implementing a successful therapy can be challenging due to the variety of clinically similar differential diagnoses. Degenerative pathologies of the Achilles tendon frequently cause posterior heel pain and are subdivided into insertional tendinopathy (often associated with dorsal heel spurs) and mid portion tendinopathy, which is situated in a hypovascular ”critical zone” 2 to 6cm proximal to the calcaneal insertion site. Other typical disorders causing dorsal heel pain are retro-calcaneal or retro-Achilles bursitis, bony deformities (Haglund́s Syndrome), accessory ossicles (Os trigonum), calcaneal apophysitis (Severˊs disease) or flexor hallucis longus entrapment. A thorough physical examination and imaging diagnostics with sonography and MRI are crucial to identify the cause of pain. The therapy includes a wide range of conservative and surgical options depending on the main pathology.

Low-dose radiation treatment for painful plantar enthesophyte: a highly effective therapy with little side effects

AimPlantar enthesophyte is a common degenerative disorder. Surgical and medical treatment options are associated with either poor outcome or high percentage of relapse. Observations have indicated a beneficial effect of radiation therapy. We therefore wanted to evaluate pain reduction using orthovolt or cobalt-based radiation treatment for painful plantar enthesophyte and determine long-term response as well as prognostic parameters in this condition.MethodsWe identified a total of 102 consecutive patients treated for a total of 117 symptomatic heel spurs. 59 patients were treated with cobalt radiation, 31 patients with orthovolt therapy and 12 patients with both radiation systems. Primary outcome measure was pain reduction being scored using the modified Rowe Score prior therapy, at the end of each treatment series as well as after 6 weeks. Secondary outcome measure was long-term outcome, evaluated in patients with a follow-up period of longer than 3 years.ResultsBefore radiation therapy, 61 patients (60.4%) had a score of 0, significant strong pain. At the time of completion of radiation treatment, 3 patients (2.7%) were pain-free (score of 30), whereas 8 patients (7.9%) had still severe pain (score 0). 6 weeks after radiation therapy, 33 patients (32.7%) were pain-free and 8 patients (7.9%) had severe pain (score 0), while at the time data of collection, 74 patients (73%) were free of pain and 1 patient (1%) had strong pain (score 0). Duration of pain before the start of radiation treatment was a significant prognostic factor (p = 0.012) for response to treatment.ConclusionRadiotherapy of painful plantar enthesophyte is a highly effective therapy with little side effects providing long-term therapeutic response. The only significant prognostic parameter for response to treatment is the duration of pre-radiation therapy pain. Early integration of radiation therapy in the treatment seems to result in superior pain reduction.

„Skuteczność stosowania fali uderzeniowej w wybranych dysfunkcjach narządu ruchu”

"Effectiveness of using the shock wave in selected dysfunctions of the musculoskeletal system"&#x0D; mgr. Magdalena Momot-Kuryło Rehabilitation and Sports Center "Medi-Sport" in Lublin&#x0D; dr Michał Grzegorczyk Department of Physiotherapy Rehabilitation, Chair of Rehabilitation and Balneotherapy, Faculty of Health Sciences, Medical University of Lublin.&#x0D; &#x0D; Introduction&#x0D; In medicine, the shockwave was first used in the 1980s for lithotripsy [1]. Over time, new reports appeared about its positive impact on the human body, including on the musculoskeletal system. Nowadays it is successfully used in many fields of medicine.&#x0D; &#x0D; Objective of the work&#x0D; The aim of the study was to evaluate the effectiveness of the shock wave application in patients with patellar ligament enthesopathy, lateral epicondylitis of the humerus and heel spur.&#x0D; &#x0D; Material and methods&#x0D; The research was carried out in CM Luxmed, ul. Zwycięska 6a and CM MEDISPORT at ul. Łabędzia in Lublin in the period from 01/12/2020. until December 10, 2021 75 patients took part in them. 25 of them were diagnosed with patellar ligament enthesopathy, another 25 with lateral epicondylitis of the humerus. The remaining 25 people received shock wave treatments for the heel spur. Each respondent underwent 5 shock wave treatments. Before starting the research, the respondents were informed about the purpose of the research. Moreover, they were guaranteed anonymity.&#x0D; &#x0D; Results:&#x0D; Among the surveyed people, in general, 50.7% (n = 38) of all respondents were women, and 49.3% (n = 37) - men. 36% (n = 9) women and 64% (n = 16) men were among the respondents treated for lateral epicondylitis of the humerus. In the case of the jumper's knee, the study group consisted of 60% (n = 15) women and 40% (n = 10) men, while in the group of patients with the heel spur, women constituted 56% (n = 14), and men 44% (n = 11).&#x0D;

Calcaneal Inferior Spur Fracture Obvious but Easily Missed

Calcaneal inferior spurs are bony outgrowth that can arise from multiple sites. Compressive and traction forces are theorized to be the etiology behind their genesis. Blunt trauma to the plantar aspect of the foot can lead to calcaneal inferior spur fracture. We present a case of a 38-years-old male presenting inability to bear weight on his left foot with point tenderness after falling from a 3-meters height. Radiographic examination revealed fracture of calcaneal inferior spur, from which the patient was conservatively treated successfully. Fracture inferior calcaneal spur is a rare cause of heel pain. The reviewed literature showed how both conservative and surgical managements are used, the former more frequently.

Endoscopic Insertional Achilles Reconstruction with Double Row Suture Bridge Reconstruction: A Technique Tip

Category:Ankle; ArthroscopyIntroduction/Purpose:Insertional Achilles tendinopathy can be a debilitating condition that often fails to improve with non- surgical management such as bracing and physical therapy. Traditional surgical techniques include an open debridement of the diseased tendon and resection of calcaneal spurs. This is followed by repair of the tendon. Suture anchors are often used to secure the tendon, but recent advances in tendon fixation, including the advent of double row repairs, has allowed better biomechanical repairs and faster rehabilitation. Additionally, minimally invasive surgery (MIS) and endoscopic techniques have advanced to allow successful treatment of all aspects of the condition while minimizing wound complications and infectionMethods:The authors present a technique to treat insertional Achilles tendinopathy and calcaneal bone spurs using MIS techniques while also incorporating a percutaneous double row suture anchor repair. The technique utilizes four portals to access two endoscopic working planes. The burr is inserted deep to the tendon and the calcaneoplasty is performed. Subsequently, the endoscope is inserted alongside a shaver to remove bony debris and debulk the anterior aspect of the Achilles areas of tendinopathy. Following this, the portals are used to place a double row suture anchor repair.Results:With over 75 surgeries performed, there have been zero wound complications and patients have been able to return to full weight bearing within 10 days after surgery. Follow up outcome data is currently being collected and will be reported as a case series once sufficient patients have completed their follow up.Conclusion:This study presents double-row repair following an endoscopic assisted MIS calcaneoplasty and Achilles debridement. The technique combines the benefits of the double row suture bridge repair with a minimal incision technique to debride the insertional tendinosis. In order to adequately debride the tendon and the posterior calcaneal tuberosity, the tendon foot print is elevated as the burr removes the bone at the insertion. The anterior portion of the tendon, which may be a pain generator as well, isdebrided endoscopically with the shaver. Finally, a double row suture bridge repair is performed in order to allow early weight bearing and rehabilitation.