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Calcaneal osteotomy for the treatment of plantar fasciitis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Plantar fascia release is the main procedure for plantar fasciitis which does not respond to conservative treatment. However, this procedure is sometimes accompanied by lateral column pain due to loss of the longitudinal arch height after surgery. To avoid this complication, we performed calcaneal osteotomy. The aim of this study was to clarify the efficacy of this procedure.

Methods

A retrospective clinical and radiographic study was conducted for 11 patients (11 feet) who had undergone calcaneal osteotomy for the treatment of intractable plantar fasciitis. Three of the patients were males and eight were females, with an average age of 46 (range 24–70) years. Calcaneal osteotomy was performed from 1 cm anterior of the calcaneal attachment of the plantar fascia to 1 cm anterior of the calcaneal attachment of the Achilles tendon, and the proximal fragment was displaced approximately 5 mm in the plantar direction. The patients with a pronated foot before surgery underwent an additional approximately 5 mm medial displacement of the proximal fragment.

Result

Significant improvement was seen between the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score before surgery and at final follow-up (P < 0.0001). With regard to the radiographic parameters which evaluated longitudinal arch height, significant improvement was seen between the talar pitch (P = 0.0002), calcaneal plantar angle (P < 0.0001) and lateral talocalcaneal angle (P = 0.0251) before and at 2 years after surgery. One patient with severe pes planus before surgery showed poor clinical and radiographic results.

Conclusions

This procedure can bring about good results in patients who do not have severe pes planus.

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References

  1. Anderson DJ, Fallat LM, Savoy-Moore RT (2001) Computer-assisted assessment of lateral column movement following plantar fascia release: a cadaveric study. J Foot Ankle Surg 40:52–70

    Article  Google Scholar 

  2. Bazaz R, Ferkel RD (2007) Results of endoscopic plantar fascia release. Foot Ankle Int 28:549–556. doi:10.3113/FAI.2007.0549

    Article  PubMed  Google Scholar 

  3. Bordelon R (1993) Heel pain. In: Mann RA (ed) Surgery of the foot and ankle. CV Mosby, St Louis, pp 837–847

    Google Scholar 

  4. Boyle RA, Slater GL (2003) Endoscopic plantar fascia release: a case series. Foot Ankle Int 24:176–179

    CAS  PubMed  Google Scholar 

  5. Brugh AM, Fallat LM, Savoy-Moore RT (2002) Lateral column symptomatology following plantar fascia release: a prospective study. J Foot Ankle Surg 41:365–371

    Article  PubMed  Google Scholar 

  6. Downey MS (1998) Endoscopic plantar fasciotomy remains controversial. Biomechanics 5:33–39

    Google Scholar 

  7. Garceau DD, Dean D, Requejo SM, Thordarson DB (2003) The association between diagnosis of plantar fasciitis and windlass test results. Foot Ankle Int 24:251–255

    PubMed  Google Scholar 

  8. Gill LH (1997) Plantar fasciitis: diagnosis and conservative management. J Am Acad Orthop Surg 5:109–117

    PubMed  Google Scholar 

  9. Kalen V, Brecher A (1988) Relationship between adolescent bunions and flatfeet. Foot Ankle 8:331–336

    CAS  PubMed  Google Scholar 

  10. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353

    CAS  PubMed  Google Scholar 

  11. Kwong PK, Kay D, Voner RT, White MW (1988) Plantar fasciitis. Mechanics and pathomechanics of treatment. Clin Sports Med 7:119–126

    CAS  PubMed  Google Scholar 

  12. Leach R, Seavey M, Salter D (1986) Results of surgery in athletes with plantar fasciitis. Foot Ankle Int 7:156–161

    CAS  Google Scholar 

  13. Lemont H, Ammirati KM, Usen N (2003) Plantar fasciitis: a degenerative process (Fasciosis) without inflammation. J Am Podiatr Med Assoc 93:234–237

    PubMed  Google Scholar 

  14. Lutter L (1986) Surgical decisions in athletes’ subcalcaneal pain. Am J Sports Med 14:481–486. doi:10.1177/036354658601400609

    Article  CAS  PubMed  Google Scholar 

  15. Martin RL, Irrgang JJ, Conti SF (1998) Outcome study of subjects with insertional plantar fasciitis. Foot Ankle Int 19:803–811

    CAS  PubMed  Google Scholar 

  16. Murphy GA, Pneumaticos SG, Kamaric E, Noble PC, Trevino SG, Baxter DE (1998) Biomechanical consequences of sequential plantar fascia release. Foot Ankle Int 19:149–152

    CAS  PubMed  Google Scholar 

  17. O’Malley MJ, Page A, Cook R (2000) Endoscopic plantar fasciotomy for chronic heel pain. Foot Ankle Int 21:505–510

    PubMed  Google Scholar 

  18. Sammaro GJ, Helfrey RB (1996) Surgical treatment of recalcitrant plantar fasciitis. Foot Ankle Int 17:520–526

    Google Scholar 

  19. Wearing SC, Smeathers JE, Yates B, Sullivan PM, Urry SR, Dubois P (2004) Sagittal movement of the medial longitudinal arch is unchanged in plantar fasciitis. Med Sci Sports Exerc 176:1–1767

    Google Scholar 

  20. Wolgin M, Cook C, Graham C, Mauldin D (1994) Conservative treatment of plantar heel pain: long term follow-up. Foot Ankle 15:97–102

    CAS  PubMed  Google Scholar 

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Correspondence to Wataru Miyamoto.

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Miyamoto, W., Takao, M. & Uchio, Y. Calcaneal osteotomy for the treatment of plantar fasciitis. Arch Orthop Trauma Surg 130, 151–154 (2010). https://doi.org/10.1007/s00402-009-0879-8

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  • DOI: https://doi.org/10.1007/s00402-009-0879-8

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