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first-step pain as indicator of surgical success

Posted by BrianJ on 9/23/03 at 14:25 (130808)

Carl W asked a good question on the Surgery Board that never really got answered. Thus, I'm asking it here and hoping for a direct answer (at least as direct as possible given the vagaries of surgery and the differences among patients). Here's the question: Is surgical PF release generally more successful in patients that had 'first-step' pain prior to surgery?

Re: first-step pain as indicator of surgical success

Ed Davis, DPM on 9/23/03 at 15:19 (130814)

Brian:

Most, but not all, patients with PF have first step pain. If no first step pain exists one may still have PF but other areas need to be looked at. There are no studies from which to answer your question and have no way to come up with a good answer other than to say: Those with first step pain are more likely to have PF as the correct (or complete) diagnosis and as such, a plantar fascial release would be more likely to be successful. In other words, if that surgery has a 60% overall success rate and that success rate is applied to a group with a diagnostic accuracy rate of 95% vs. a group with an 85% diagnostic accuracy rate (ie. the no first step pain group) then the first group will have higher success rate with the surgery.
Ed

Re: first-step pain as indicator of surgical success

Dr. Z on 9/23/03 at 17:15 (130828)

Yes.