Istanbul, Turkey:
K. Karaytug et al. compared isolated percutaneous plantar fascia release by using a needle versus percutaneous plantar fascia release combined with calcaneal decompression in treatment of the patients with resistant heel pain.
The authors reviewed the prospectively recorded data of patients who treated and follow-up for resistant heel pain (treated more than 6 months with other treatment modalities) with a minimum 1-year follow-up.
Calcaneal drilling was performed under general or spinal anesthesia with the patient placed in the lateral decubitus position. Calcaneal decompression was performed percutaneously using a Kirschner wire under fluoroscopy with 3 to 6 drill holes in the inferior cortex.
Twenty patients were treated with plantar fascia release using a needle (group 1) and 21 patients were treated with a similar percutaneous release combined with calcaneal decompression (group 2). Functional outcomes were evaluated using visual analog scale (VAS) and Foot Function Index (FFI) pre- and postoperatively.
No significant differences were observed between both groups in terms of age (44.3 years in group 1 vs 46.8 years in group 2), gender (18 females and 2 males in group 1 vs 19 females and 3 males in group 2), body mass index (25.1 in group 1 vs 26.3 in group 2), and follow-up (14.6 months in group 1 vs 15.7 months in group 2).
The decrease in postoperative FFI (Foot Function Index) and VAS (Visual Analogue Scale) scores compared with preoperative VAS scores was statistically significant in both groups. However, improvement of FFI and VAS score was significantly higher in group 2 than group 1.
Although both methods are very effective in the treatment of persistent heel pain, the group 2 has a better improvement in functional scores than group 1 with a mean 15 months following the procedure.
The authors concluded that - percutaneous release of the plantar fascia in persistent heel pain enables patients to achieve satisfactory functional results. Calcaneal drilling is an effective method to increase the success rate and carries a low risk of complication. Although both methods are very effective in the treatment of persistent heel pain, the group 2 had a better improvement in functional scores than the group 1 within 15 months following surgery.
Further reading:
Comparison of the Isolated Plantar Fascia Release Versus Plantar Fascia Release Combined With Calcaneal Decompression in Management of the Patients With Resistant Heel Pain
Kayahan Karaytug, Serkan Bayram, Mehmet Ekinci, Onder Murat urmeydan, Sefa Giray Batibay.
The Journal of Foot & Ankle Surgery 61 (2022) 459−463
https://doi.org/10.1053/j.jfas.2021.09.017