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SURGICAL RESECTION OF PLANTAR FASCIOSIS USING A MINI-TRANSVERSE INCISION: TWO TO TEN-YEAR FOLLOW-UP



Abstract

Introduction and Aims: The purpose of this study was to report our results of surgical resection of plantar fasciosis without a full release using a small transverse plantar incision.

Method: All patients who had a surgical resection for plantar fasciosis at our institution from July 1992 to November 2000 were identified. All surgeries were performed by the senior author (R.P.N.). A small transverse plantar incision was utilised. The focus of the operative technique was identification and resection of only the pathologic fasciosis tissue. A full release of normal plantar fascia was not performed, and the associated calcaneal traction spur was addressed only if easily accessible with the fasciosis resection. Patients were then contacted and asked to fill out a scoring sheet developed at our institution that relates to pain, function, and patient satisfaction after plantar fasciosis resection. This was compared to a scoring sheet that rated the same parameters just prior to surgery. A Wilcoxan signed ranks test was used to compare the results. The incidence of patient and physician noted wound complications were also recorded.

Results: Twelve patients had 15 plantar fasciosis resection operations between July 1992 and November 2000. Of these 12, three were lost to follow-up. The remaining nine patients, four men and five women, had 12 operations (three were bilateral). The ages of the patients at time of surgery ranged from 34 to 72 years. Time of follow-up ranged from two to 10 years (average 6.25 years). There were six left and six right feet for comparison. The pain rating of patients improved from a median of five to 25 (p=0.011). The functional score improved from a median of 3.75 to 25 (p=0.007). The satisfaction of the patients improved from a median of zero to 15 (p=0.007). Patients reported no complaints of wound dehiscence, chronic pain or paresthesias from their plantar incision.

Conclusions: Plantar fasciosis can be effectively treated with acceptable long-term results with a mini-transverse plantar incision that resects only pathologic fasciosis tissue. A full release of the plantar fascia or resection of the calcaneal traction spur is unnecessary for surgical success.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

At least one of the authors is receiving or has received material benefits or support from a commercial source.