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. ID: 98158346 TITLE: Complications of plantar fascia rupture associated with corticosteroid injection. AUTHOR: Acevedo JI; Beskin JL ADDRESS: Georgia Baptist Medical Center, Atlanta, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng REGISTRY NUMBERS: 0 (Adrenal Cortex Hormones)
ABSTRACT
: From 1992 to 1995, 765 patients with a clinical diagnosis of plantar fasciitis were evaluated by one of the authors. Fifty-one patients were diagnosed with plantar fascia rupture, and 44 of these ruptures were associated with corticosteroid injection. The authors injected 122 of the 765 patients, resulting in 12 of the 44 plantar fascia ruptures. Subjective and objective evaluations were conducted through chart and radiographic review. Thirty-nine of these patients were evaluated at an average 27-month follow-up. Thirty patients (68%) reported a sudden onset of tearing at the heel, and 14 (32%) had a gradual onset of symptoms. In most cases the original heel pain was relieved by rupture. However, these patients subsequently developed new problems including longitudinal arch strain, lateral and dorsal midfoot strain, lateral plantar nerve dysfunction, stress fracture, hammertoe deformity, swelling, and/or antalgia. All patients exhibited diminished tension of the plantar fascia upon examination by the stretch test. Comparison of calcaneal pitch angles in the affected and uninvolved foot showed a statistically significant difference of 3.7 degrees (P = 0.0001). Treatment included NSAIDs, rest or cross-training, stretching, orthotics, and boot-brace immobilization. At an average 27-month follow-up, 50% had good/excellent scores and 50% had fair/poor scores. Recovery time was varied. Ten feet were asymptomatic by 6 months post rupture, four feet by 12 months post rupture, and 26 feet remained symptomatic 1 year post rupture. Our findings demonstrate that plantar fascia rupture after corticosteroid injection may result in long-term sequelae that are difficult to resolve. SOURCE: Foot Ankle Int 1998 Feb;19(2):91-7 2
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. ID: 98181948 TITLE: A randomized controlled evaluation of low-intensity laser therapy: plantar fasciitis. AUTHOR: Basford JR; Harmsen WS; Krause DA; Malanga GA ADDRESS: Department of Physical Medicine and Rehabilitation, Mayo Clinic and Foundation, Rochester, MN 55905, USA. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL LANGUAGE: Eng
ABSTRACT
: OBJECTIVE: To determine whether low-intensity laser irradiation, a widespread but controversial physical therapy agent, is an effective treatment of plantar fasciitis. DESIGN: A randomized, double-blinded, placebo-controlled clinical study. SETTING: A sports medicine clinic. SUBJECTS: Thirty-two otherwise healthy individuals with plantar fasciitis of more than 1 month's duration. INTERVENTION: Dummy or active irradiation with a 30 mW .83 microm GaAlAs continuous-wave infrared (IR) diode laser three times a week for 4 weeks. MEASUREMENTS: Morning pain, pain with toe walking, tenderness to palpation, windlass test response, medication consumption, and orthotic use were evaluated immediately before the study, as well as at the midpoint and end of treatment. Subjects were also evaluated at a follow-up 1 month after their last treatment. RESULTS: No significant differences were found between the groups in any of the outcome measures either during treatment or at the 1-month follow-up. Treatment, however, was well tolerated and side effects were minimal. CONCLUSIONS: Low-intensity IR laser therapy appears safe but, at least within the parameters of this study, is not beneficial in the treatment of plantar fasciitis. SOURCE: Arch Phys Med Rehabil 1998 Mar;79(3):249-54 3
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. ID: 98164520 TITLE: Retrospective analysis of minimal-incision, endoscopic, and open procedures for heel spur syndrome. AUTHOR: Brekke MK; Green DR ADDRESS: Scripps Mercy Medical Center, San Diego, CA, USA. PUBLICATION TYPES: HISTORICAL ARTICLE JOURNAL ARTICLE LANGUAGE: E
Arabia. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: A prospective single survey was conducted among Security Forces personnel at the Mobile Hospital, Ministry of Interior, Makkah Al-Mukarramah, Saudi Arabia. One hundred three patients presented to the orthopedic clinic with painful heel. A control group of patients from the other clinics without painful heel was also screened. The average age was 38.81 years and 38.1 years in the patient and the control group, respectively. The mean Quetelet index of body mass in the patient group was 30.36 kg/m2 and in the control group it was 26.71 kg/m2. There was a statistically significant difference of p < 0.05 between the two groups for Quetelet index of body mass. The right side was affected in 37 patients, the left side was involved in 45 patients, and 21 patients had pain bilaterally. Seventy-one patients had spur on the calcaneum. The prevalence of painful heel attributable to plantar fasciitis/calcaneum spur was 1.18%. This study suggests that obesity is a cause and initiator of heel pain and plantar fasciitis/calcaneal spur and that improper footwear aggravates the condition. SOURCE: Mil Med 1998 Jan;163(1):56-7 7
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. ID: 98154548 TITLE: Iontophoresis of 0.4% dexamethasone for plantar fasciitis. AUTHOR: Chandler TJ ADDRESS: Lexington Clinic Sports Medicine Center, Lexington, Kentucky, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng REGISTRY NUMBERS: 0 (Glucocorticoids, Synthetic) 50-02-2 (Dexamethasone) SOURCE: Clin J Sport Med 1998 Jan;8(1):68 8
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. ID: 98039111 TITLE: MRI of plantar fasciitis. AUTHOR: Roger B; Grenier P ADDRESS: Service de Radiologie Polyvalente Diagnostique et Interventionelle, Hopital de la Pitie, 83, boulevard de l'Hopital, F-75651 Paris Cedex 13, France. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: At present, MRI is the only imaging method that can precisely visualize lesions of the superficial plantar aponeurosis, whether they be musculoaponeurositides, enthesopathies or tears, and whether they be acute or chronic, with or without complications. By its direct visualization of the lesion, MRI enables an accurate assessment of the injury to be made and thereby better orients the therapeutic strategy. SOURCE: Eur Radiol 1997;7(9):1430-5 9
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. ID: 98013837 TITLE: The role of bone scintigraphy and plain radiography in intractable plantar fasciitis. AUTHOR: Tudor GR; Belton I; Allen MJ; Finlay D ADDRESS: Department of Radiology, Leicester Royal Infirmary NHS Trust, UK. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: The objective of this study was to assess the role of bone scintigraphy and plain film radiography in intractable plantar fasciitis. The bone scintigrams, radiographs and clinical histories of 33 patients with chronic plantar fasciitis were reviewed. These patients were refractory to conservative treatments and were being considered for surgical plantar fascia release. Twenty-eight patients had increased uptake on scintigraphy at the medial calcaneal tubercle, while a plantar spur was seen in 21 patients. Seventy-five percent of patients with increased uptake had a calcaneal spur; 95% of patients with a spur had increased uptake on scintigraphy. It would appear that plantar calcaneal spurs are more prevalent in this group of patients than in the general population and, although they may not be the primary cause of pain, they may predispose to it. Scintigraphy was helpful in patients without a spur or with atypical symptoms or signs. It did not provide any further information on the group of patients with a spur. SOURCE: Nucl Med Commun 1997 Sep;18(9):853-6 10
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. ID: 98059214 TITLE: An inexpensive "orthosis" for plantar fasciitis [letter; comment] AUTHOR: de Souza H; Reed L COMMENTS: Comment on: Med J Aust 1997 Jun 2;166(11):616 PUBLICATION TYPES: COMMENT LETTER LANGUAGE: Eng SOURCE: Med J Aust 1997 Nov 3;167(9):509 11
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. ID: 98038439 TITLE: Keeping
ADDRESS: Wright State University, Department of Orthopaedic Surgery, Dayton, Ohio 45409, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Endoscopic plantar fascia release is a new procedure proposed to treat heel pain and plantar fasciitis. The purpose of this study was to assess the structures at risk during plantar fascia release using this method. Ten fresh-frozen cadaver feet were divided into two groups. All specimens underwent cannula placement inferior to the plantar fascia. Five-of the specimens had plantar fascia release using the endoscopic technique. Six of the specimens were then frozen and cut in transverse, sagittal, and coronal sections to visualize the relationship between the cannula and plantar fascia and surrounding structures. Gross dissection was performed on the remaining four specimens. The amount of plantar fascia released, the relationship to the nerve to abductor digiti minimi, and the fascia of the abductor hallucis muscle were assessed. The average distance from the cannula margin to the nerve to the abductor digiti minimi was 6 mm at the medial border of the plantar fascia. The average amount of plantar fascia released was 90%. Although a complete release was attempted, the fascia to the abductor hallucis was not released in any of the specimens. The nerve to the abductor digiti minimi was not damaged in any of the specimens. On coronal sections, the nerve was closer to the cannula and plantar fascia release than previously reported. SOURCE: Foot Ankle Int 1997 Jul;18(7):398-401 14
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. ID: 96417197 TITLE: Estimation of sex on the basis of radiographs of the calcaneus. AUTHOR: Riepert T; Mattern R; Nafe B; Schild H; Drechsler T ADDRESS: Institut fur Rechtsmedizin der Johannes Gutenberg-Universitat, Mainz, Germany. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Lateral and anteroposterior radiographs of the ankles of 800 Central Europeans aged 20 to 79 were analyzed with regard to sexual dimorphism. All the distances, but not the angles, of the calcaneus were much larger in males than in females. Approximately 80% of the study sample could be sexed correctly by classifying all specimens greater than 86.0 mm in length as male and those less than 86.0 mm as female. The prevalence of os tibiale externum was 8.0 and 2.6% and the prevalence of plantar heel spur was 16.3 and 6.5% (increasing with age) for males and females, respectively, being significantly more frequent in females. On the other hand, the bone island frequencies were 9.1% in males and 4.8% in females. Our study suggests that radiographs of the ankle are a convenient, rapid, cheap and non-invasive means for estimating sex. SOURCE: Forensic Sci Int 1996 Feb 9;77(3):133-40 15
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. ID: 96098454 TITLE: An anatomic analysis of endoscopic plantar fascia release. AUTHOR: Hawkins BJ; Calhoun JH; Gibbons T; Langermen RJ Jr ADDRESS: Central States Orthopedic Specialists, Tulsa, Oklahoma 74136, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Eighteen fresh-frozen cadaver foot specimens underwent release of the plantar fascia via a newly described endoscopic technique. A 75% release was attempted on each specimen in order to represent a partial fascial release. Each specimen was then dissected to assess the success of the procedure. Five separate measurements were recorded evaluating the reproducibility of the procedure, adequacy of the release considering accepted etiologies for chronic heel pain, and the possibility of damage to local structures. Partial release was noted to be possible, but controlling the exact percentage of the incision was difficult. The release averaged 82% of the width of the fascia, with a range of 53% to 100%. There was no damage in any specimen to the first branch of the lateral plantar nerve, the structure considered most at risk during the procedure. Release of the deep fascia of the abductor hallucis muscle was not possible with this approach. SOURCE: Foot Ankle I
that orthotics have any effect on knee alignment and, while they can alter subtalar joint alignment, the clinical benefit of this remains unclear. Awareness of anatomical factors that may predispose to overuse injuries allows the clinician to develop individual prehabilitation programmes designed to decrease the risk of overuse injury. In addition, the clinician can advise the athlete on the importance of avoiding extrinsic factors that may also predispose to overuse injury. SOURCE: Sports Med 1997 Aug;24(2):132-46 18
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. ID: 97457528 TITLE: Clinical snapshot: plantar fasciitis. AUTHOR: Campbell-Giovaniello KJ ADDRESS: Veterans Administration Outpatient Clinic, Redding, CA, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng SOURCE: Am J Nurs 1997 Sep;97(9):38-9 19
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. ID: 97424637 TITLE: Pseudoaneurysm with an arteriovenous fistula of the tibial vessels after plantar fasciotomy: a case report. AUTHOR: Nierenberg G; Stein H; Engel A; Hoffman A ADDRESS: Rambam Medical Center, Haifa, Israel. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng SOURCE: Foot Ankle Int 1997 Aug;18(8):524-5 20
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. ID: 97401231 TITLE: Infracalcaneal heel pain in the athlete. AUTHOR: Agostinelli J; Ross JA ADDRESS: Orthopedics/Podiatry Services, Eglin Air Force Base, Florida, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGE: Eng
ABSTRACT
: Heel-spur syndrome is a condition encountered on a daily basis by those practitioners who primarily treat athletes. The authors discuss anatomy, the clinical examination, radiographic evaluation, exercise, and alternative medicines. SOURCE: Clin Podiatr Med Surg 1997 Jul;14(3):503-9 21
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. ID: 97396647 TITLE: Treatment of plantar fasciitis with night splint and shoe modifications consisting of a steel shank and anterior rocker bottom [letter; comment] AUTHOR: Ng A COMMENTS: Comment on: Foot Ankle Int 1996 Dec;17(12):732-5 PUBLICATION TYPES: COMMENT LETTER LANGUAGE: Eng SOURCE: Foot Ankle Int 1997 Jul;18(7):458 22
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. ID: 97395411 TITLE: Fortnightly review. Plantar fasciitis. AUTHOR: Singh D; Trevino SG; Bentley G; Angel J ADDRESS: Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGE: Eng SOURCE: BMJ 1997 Jul 19;315(7101):172-5 23
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. ID: 97338957 TITLE: Isolated peripheral enthesitis and/or dactylitis: a subset of psoriatic arthritis. AUTHOR: Salvarani C; Portioli I; Ferri S; Padula A Niccoli L; Macchioni P; Olivieri I; Cantini F ADDRESS: Unita Reumatologica, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. PUBLICATION TYPES: JOURNAL ARTICLE MULTICENTER STUDY LANGUAGE: Eng
ABSTRACT
: OBJECTIVE: To identify isolated peripheral enthesitis and/or dactylitis as a subset of psoriatic arthritis (PsA) and to define the clinical characteristics of these patients. METHODS: We examined 401 unselected patients with PsA seen in 3 Italian rheumatological centers over a 6 month period. The diagnosis of PsA was based upon the clinical experience of a rheumatologist. The clinical features of patients with PsA were assessed by clinical examination and review of the patients' charts, evaluating the presence of peripheral arthritis, spinal involvement, dactylitis, and enthesitis. A series of 483 rheumatological patients without psoriasis and spondyloarthropathy (European Spondylarthropathy Study Group criteria) seen consecutively in a one month period constituted the control group. RESULTS: 14 patients (3.5%) presented isolated episodes of peripheral enthesitis and/or dactylitis. No patient developed peripheral arthritis and/or axial involvement during the followup period (median 30 mo; range 3-72 mo). 10/14 patients (71%) presented at least one episode of finger and/or toe dactylitis. 5 of these 10 patients (50%) had additional episodes of peripheral enthesitis (Achilles tendinitis, plantar fasciitis, and posterior tibial tendinitis). Episodes of Achilles ten
relief than traditional modalities alone. Forty affected feet were randomly assigned to one of two groups. Group I feet were treated with traditional modalities and placebo iontophoresis. Group II feet received the traditional modalities plus iontophoresis of dexamethasone. Both groups were treated six times over 2 weeks. The subjects' clinical course was assessed using the Maryland Foot Score. At the conclusion of treatment, Group II patients had significantly greater improvement than Group I patients (increase on Maryland Foot Score of 6.8 +/- 5.6 for Group II and 3.1 +/- 4.1 for Group I). However, at followup 1 month after completion of treatment there was no significant difference between groups (increase of 5.6 +/- 8.0 for Group I and 7.4 +/- 6.3 for Group II). These results suggest that although traditional modalities alone are ultimately effective, iontophoresis in conjunction with traditional modalities provides immediate reduction in symptoms. Based on these results, iontophoresis of dexamethasone for plantar fasciitis should be considered when more immediate results are needed (i.e., performance athletes and active patients. SOURCE: Am J Sports Med 1997 May-Jun;25(3):312-6 26
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. ID: 97344828 TITLE: An inexpensive "orthosis" for plantar fasciitis [letter] [see comments] AUTHOR: White AD COMMENTS: Comment in: Med J Aust 1997 Nov 3;167(9):509 PUBLICATION TYPES: LETTER LANGUAGE: Eng SOURCE: Med J Aust 1997 Jun 2;166(11):616 27
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. ID: 97041507 TITLE: Outcome of nonsurgical treatment for plantar fasciitis [published erratum appears in Foot Ankle Int 1996 Nov;17(11):722] AUTHOR: Gill LH; Kiebzak GM ADDRESS: Miller Orthopaedic Clinic, Charlotte, North Carolina 28203, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Four hundred eleven patients with a clinical diagnosis of plantar fasciitis were assessed for predisposing factors. Each patient completed an outcomes assessment survey instrument that ranked effectiveness of various nonsurgical treatment modalities. Listed in descending order of effectiveness, the treatment modalities assessed were short leg walking cast, steroid injection, rest, ice, runner's shoe, crepe-soled shoe, aspirin or nonsteroidal anti-inflammatory drug, heel cushion, low-profile plastic heel cup, heat, and Tuli's heel cup. Treatment with a cast ranked the best. The Tuli's heel cup ranked the poorest. Most of the treatments were found to be unpredictable or minimally effective. The ineffectiveness of nonsurgical treatments noted in this outcomes study is at variance with most published clinical studies in which generally favorable results are reported after nonsurgical treatment for plantar fasciitis. SOURCE: Foot Ankle Int 1996 Sep;17(9):527-32 28
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. ID: 97329754 TITLE: Effect of cutting the plantar fascia on mechanical properties of the foot. AUTHOR: Arangio GA; Kim W; Chen C ADDRESS: Department of Surgery, Lehigh Valley Hospital, Allentown, PA, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: A biomechanical model was used to calculate the loadbearing characteristics of the plantar fascia and to determine the effect of cutting the plantar fascia on the stiffness of the foot. With a load of 683 N applied to the foot, the model predicted a 17% increase in vertical displacement and a 15% increase in horizontal elongation when the plantar fascia was cut, compared with the corresponding value when the plantar fascia was intact. Plantar fasciotomy, although clinically satisfactory in cases of recalcitrant heel pain, decreases the stiffness of the foot and creates a less rigid and more deformable arch. The biomechanical model described can help to evaluate the possible outcome of such a procedure. SOURCE: Clin Orthop 1997 Jun;(339):227-31 29
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. ID: 97328875 TITLE: A prospective study of Plantar fasciitis in Harare. AUTHOR: Chigwanda PC ADDRESS: Department of Surgery, University of Zimbabwe Medical School, Avondale, Harare, Zimbabwe. PUBLICAT
heel pain and their associated imaging findings. SOURCE: Clin Podiatr Med Surg 1997 Apr;14(2):281-301 31
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. ID: 97232439 TITLE: Plantar fasciitis: US evaluation [letter; comment] AUTHOR: Gibbon W; Long G COMMENTS: Comment on: Radiology 1996 Oct;201(1):257-9 PUBLICATION TYPES: COMMENT LETTER LANGUAGE: Eng SOURCE: Radiology 1997 Apr;203(1):290 32
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. ID: 97272504 TITLE: Intravascular fasciitis in the foot. AUTHOR: Sticha RS; Danforth RD Jr; Wertheimer SJ; Deacon JS ADDRESS: Department of Podiatric Surgery, St. John Hospital-Macomb Center, Harrison Township, Michigan, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW OF REPORTED CASES LANGUAGE: Eng
ABSTRACT
: Intravascular fasciitis is a rare benign condition characterized by reactive fibroblastic proliferation arising from the superficial or deep fascia and involving arteries and/or veins. Intravascular fasciitis is a distinct variant of a more common condition called nodular or pseudosarcomatous fasciitis, which possesses clinical and histologic features similar but lacks vascular invasion. The fibroblastic violation of the vascular network suggests a malignant component and often leads to an inappropriate diagnosis for this benign condition. A thorough review of the literature revealed less than 25 reported cases of intravascular fasciitis, with this publication being the only case involving the foot or ankle. A case of intravascular fasciitis affecting the plantar aspect of the foot in a pediatric patient is presented and its clinical and histologic features are discussed. SOURCE: J Foot Ankle Surg 1997 Mar-Apr;36(2):95-9 33
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. ID: 97293753 TITLE: The painful foot, Part II: Common rearfoot deformities. AUTHOR: Van Wyngarden TM ADDRESS: University of Kansas Medical Center, Kansas City, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGE: Eng
ABSTRACT
: As with deformities of the forefoot, deformities of the rearfoot often respond well to conservative therapy. Rest and nonsteroidal anti-inflammatory medications are often used. Patients with plantar fasciitis may benefit from corticosteroid injections. Surgery may be helpful in refractory cases. Haglund's deformity is associated with pain in the area of the osseous ridge on the posterosuperior aspect of the calcaneus. The retrocalcaneal bursa may be inflamed. This disorder is diagnosed by palpation of the painful area. Conservative treatment consists of minimizing pressure over the osseous ridge. Corticosteroid injection is not advised since it may weaken the Achilles tendon. Surgical intervention consists of resection or reduction of the osseous ridge. Posterior calcaneal spur is another cause of heel pain. The spur can be visualized radiographically in the tendon insertion. Treatment is conservative, with footgear modification and nonsteroidal anti-inflammatory drug therapy. Surgery to remove the spur may be indicated if conservative measures fall to relieve the pain. Tarsal tunnel syndrome is characterized by pain and numbness from the medial malleolus to the sole of the foot. Conservative treatment includes reducing abnormal pronation with an orthosis. SOURCE: Am Fam Physician 1997 May 1;55(6):2207-12 34
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. ID: 97227145 TITLE: Repetitive strain injury to the foot in elite women kendoka. AUTHOR: Nunn NR; Dodd IP; Dyas JW ADDRESS: Cheltenham and Gloucester College of Higher Education, United Kingdom. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: OBJECTIVE: To account for the apparent high incidence of pain in the feet of elite women kendo players. METHODS: A clinical evaluation was done by a chiropractor, the women were interviewed about their kendo experience, and the conditions and frequency of training and ground reaction forces were measured on a Kistler force plate during the kendo attacking action. RESULTS: Four out the five women presented with plantar fasciitis. They had all practised for some time on wooden floors laid on concrete, for
Thirty patients who suffered from persistent symptoms for more than 12 months qualified for low-energy ESWT and were assigned at random to two groups, real or simulated ESWT. Before beginning the treatment, any other therapy was stopped for a period of 6 weeks. The shock waves were applied by a experimental device allowing exact localization through an integrated fluoroscopy unit. Patients were treated three times at weekly intervals. Each time 1000 impulses of 0.06 mJ/mm2 were given around the heel spur. Follow-ups were done after 3, 6, 12 and 24 weeks. Patients of the placebo group who did not improve at the 6-week follow-up were then offered ESWT therapy and were checked at 3, 6, 12 and 24 weeks after the last treatment. Whereas we noticed no significant differences between the groups before ESWT, there was a significant alleviation of pain and improvement of function at all follow-ups in the treatment group. SOURCE: Arch Orthop Trauma Surg 1996;115(2):75-9 37
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. ID: 97129386 TITLE: Treatment of plantar fasciitis with a night splint and shoe modification consisting of a steel shank and anterior rocker bottom [see comments] AUTHOR: Mizel MS; Trepman E; Marymont JV COMMENTS: Comment in: Foot Ankle Int 1997 Jul;18(7):458 ADDRESS: Department of Orthopaedics, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Seventy-one feet in 57 patients with plantar fasciitis were treated with the combination of a night splint and a shoe modification consisting of a steel shank and anterior rocker bottom. At average follow-up of 16 months, symptoms were resolved in 42 (59%), improved in 13 (18%), not changed in 11 (15%), and worse in 5 (7%) of the feet. No relation was found between outcome and age, gender, duration of symptoms, and bilateral involvement. The method is effective for the treatment of plantar fasciitis. SOURCE: Foot Ankle Int 1996 Dec;17(12):732-5 38
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. ID: 97162572 TITLE: Lower extremity injuries at the New York City Marathon. AUTHOR: Caselli MA; Longobardi SJ ADDRESS: Department of Orthopedics, New York College of Podiatric Medicine, New York, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: The purpose of this study was to determine the type and frequency of lower extremity running injuries incurred by athletes participating in the New York City Marathon. A survey was conducted of 265 athletes presenting to medical stations for podiatric care during the 1994 New York City Marathon. The results of the survey indicated that the most common injuries occurring in marathon runners were corns, calluses, blisters, muscle cramps, acute knee and ankle injuries, plantar fasciitis, and metatarsalgia. An inverse relationship was observed between the number of miles trained per week and the number of injuries. These findings are consistent with long-term studies of running injuries. SOURCE: J Am Podiatr Med Assoc 1997 Jan;87(1):34-7 39
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. ID: 96384622 TITLE: Diagnosis and treatment of heel pain in chronic inflammatory arthritis using ultrasound. AUTHOR: Cunnane G; FitzGerald O; Gibney RG; Brophy DP ADDRESS: University Department of Rheumatology, University College Dublin, St. Vincent's Hospital, Ireland. PUBLICATION TYPES: CLINICAL TRIAL JOURNAL ARTICLE LANGUAGE: Eng REGISTRY NUMBERS: 0 (Adrenal Cortex Hormones)
ABSTRACT
: The authors examined the role of ultrasound (US) in diagnosis and management of heel pain in chronic inflammatory arthritis. Nineteen patients underwent US examination. Eight patients (2 with previously unsuccessful nonguided injections), had 11 US-guided corticosteroid injections for treatment of retrocalcaneal bursitis (n = 6), plantar fasciitis (n = 3), and posterior tibial tenosynovitis (n = 2). US-demonstrated Achilles tendon rupture (n = 2), Achilles tendinitis (n = 8), posterior tibial tenosynovitis (n = 6), peroneus longus tenosynovitis (n = 2), retrocalcaneal bursitis (n = 13), and plantar fasciitis
patients (11%) had postoperative complications, including superficial wound infection (two patients), deep venous thrombosis (one patient), and superficial phlebitis (one patient), all of which resolved uneventfully with treatment. Ten patients (28.6%) reported some degree of heel pain after surgery. All 10 patients denied limitation in activity related to postoperative pain. The average period before return to daily activity and restricted work duty was 5.6 weeks and to full work duty without restriction was 8.7 weeks. Although the length of time for partial or complete resolution of symptoms is variable, a successful treatment outcome can be expected in most patients who are treated for recalcitrant plantar fasciitis. SOURCE: Foot Ankle Int 1996 Sep;17(9):520-6 42
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. ID: 97070234 TITLE: Operative treatment of subcalcaneal pain. AUTHOR: Tountas AA; Fornasier VL ADDRESS: Division of Orthopaedic Surgery, Northwestern General Hospital, Toronto, Canada. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Twenty of 21 consecutive patients (21 heels) with subcalcaneal pain retractory to conservative treatment managed by resection of the proximal attachment of the plantar fascia and the heel spur, if present, were reviewed retrospectively. The results, at a mean followup of 40 months (range, 12-102 months), using a 100 point scoring system, rated excellent in 8 patients, good in 10, fair in 1, and poor in 1 (90% satisfactory outcome). Time to maximal improvement often was prolonged, yet once reached was maintained over time. The only complication encountered was 1 superficial wound infection. Radiographically it was noted that, despite complete excision, subcalcaneal exostoses often reformed and the fascial transection never did precipitate collapse of the longitudinal arch of the foot. A combination of mucoid and fibrinoid degeneration of the plantar fascia, an acceleration of an age related process, was the principal histopathologic finding. It was concluded that the subcalcaneal pain unresponsive to conservative modalities can be treated effectively by the index procedure. The radiographic and histologic findings of this study suggest that changes within the fascia, rather than the spur, are primarily responsible for the pathogenesis of the syndrome. SOURCE: Clin Orthop 1996 Nov;(332):170-8 43
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. ID: 96431103 TITLE: Rupture of the plantar fascia. AUTHOR: Pai VS ADDRESS: Memorial Hospital, Hastings, New Zealand. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng REGISTRY NUMBERS: 53-06-5 (Cortisone)
ABSTRACT
: Rupture of the plantar fascia in athletes engaged in sports that require running and jumping has been reported. However, spontaneous degenerative rupture of the plantar fascia is not well documented in the literature. This paper reports a patient with degenerative rupture of the plantar fascia. SOURCE: J Foot Ankle Surg 1996 Jan-Feb;35(1):39-40 44
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. ID: 96413393 TITLE: Plantar fasciitis: sonographic evaluation [see comments] AUTHOR: Cardinal E; Pelletier M; Aubin B; Beauregard CG Chhem RK COMMENTS: Comment in: Radiology 1997 Apr;203(1):290 ADDRESS: Department of Radiology, Saint-Luc Hospital, Montreal, Quebec, Canada. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: PURPOSE: To evaluate the sonographic findings of plantar fasciitis. MATERIALS AND METHODS: Both feet of 15 patients who had a clinical diagnosis of plantar fasciitis were evaluated with ultrasound (US) by using a 7.0-MHz linear-array transducer. Heel pain was unilateral in 11 patients and bilateral in four. Sagittal sonograms were obtained, and the thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. Other observations included hypoechoic fascia, fiber rupture, perifascial fluid collections, and calcifications. Both feet of 15 healthy volunteers were also evaluated as a control group. RESULTS: Plantar fascia thickness was significantly increased in the heels in pat
either arm of the trial when they had resumed normal activities with minimal or no discomfort. This end point was recorded as weeks to cure. MAIN RESULTS: There was no significant difference in the demographics of the two groups (p > 0.05). In the control group, 6 of 17 were cured after an average interval of 8.8 weeks. The remaining 11 of 17 control group patients were crossed over to receive a TNS in addition to control modalities. Following cross over 8 of 11 of this group were cured after an average of 13 weeks. Three of the 11 failed to significantly respond. Of the 15 patients (16 feet) originally randomly assigned to the TNS group 16 of 16 were cured with an average treatment time of 12.5 weeks. The TNS treatment protocol was a significantly more efficacious treatment regime (p < 0.05). Thus, of 33 cases of plantar fasciitis treated in this study three failed treatment. CONCLUSION: When used in combination with a visco-elastic heel pad, stretching program and nonsteroidal anti-inflammatory drugs, the TNS is an effective treatment of plantar fasciitis. SOURCE: Clin J Sport Med 1996 Jul;6(3):158-62 46
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. ID: 96378608 TITLE: Evaluation of pediatric foot problems: Part II. The hindfoot and the ankle. AUTHOR: Manusov EG; Epperly TD; Raspa RF; Lillegard WA ADDRESS: Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGE: Eng
ABSTRACT
: The bony development of the growing child can lead to a variety of hindfoot and ankle problems. Overuse injuries are common, often occurring in conjunction with symptomatic pes planus and plantar fasciitis. Predisposing structural differences such as Haglund's disease, os trigonum, rigid and flexible pes planus, and Sever's disease merit special attention, but treatment may require only patient education and conservative management. Sprains and fractures of growing joints, however, may have poor outcomes if ignored or missed. SOURCE: Am Fam Physician 1996 Sep 1;54(3):1012-26, 1031 47
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. ID: 96272448 TITLE: The diagnosis and management of plantar fasciitis. AUTHOR: Quaschnick MS ADDRESS: Presentation College Lakota Campus, Eagle Butte, S.D., USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGE: Eng
ABSTRACT
: Plantar fasciitis is the most common diagnosis for pain in the inferior aspect of the heel and accounts for 10% of running injuries seen. It primarily afflicts the middle-aged and elderly populations and athletes. The diagnosis is relatively easy for the primary care provider to establish because of the typical presentation. Diagnostic studies usually are not warranted, but a careful history and physical examination are essential in identifying various predisposing anatomical, biomechanical, and environmental factors. This article addresses a wide array of conservative measures available in developing an individualized management approach based on the contributing factors identified. Because 90% or more respond to conservative measures, the primary care provider can manage the care of the majority of clients who present with plantar fasciitis. To avoid painful recurrence, measures effective in relieving symptoms need to be included in an ongoing plan of prevention. SOURCE: Nurse Pract 1996 Apr;21(4):50-4, 60-3, quiz 64-5 48
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. ID: 96303061 TITLE: A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome [letter; comment] AUTHOR: Wander DS COMMENTS: Comment on: J Foot Ankle Surg 1995 May-Jun;34(3):305-11 PUBLICATION TYPES: COMMENT LETTER LANGUAGE: Eng SOURCE: J Foot Ankle Surg 1996 Mar-Apr;35(2):183-4 49
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. ID: 96266724 TITLE: A review of subcalcaneal heel pain and plantar fasciitis. AUTHOR: Brown C ADDRESS: Department of Orthopaedics, Modbury Public Hospital. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Pain beneath the h
COMMENTS: Comment on: Am Fam Physician 1995 Sep 1;52(3):891-8, 901-2 PUBLICATION TYPES: COMMENT LETTER LANGUAGE: Eng SOURCE: Am Fam Physician 1996 May 1;53(6):1993; discussion 1993-4 53
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. ID: 96210168 TITLE: Plantar fasciitis, posterior night splints and activity during recovery [letter; comment] AUTHOR: Little RB COMMENTS: Comment on: Am Fam Physician 1995 Sep 1;52(3):891-8, 901-2 PUBLICATION TYPES: COMMENT LETTER LANGUAGE: Eng SOURCE: Am Fam Physician 1996 May 1;53(6):1993; discussion 1993-4 54
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. ID: 96139705 TITLE: The medial instep plantar fasciotomy [see comments] AUTHOR: Perelman GK; Sandberg NS; Figura MA COMMENTS: Comment in: J Foot Ankle Surg 1996 Mar-Apr;35(2):182-3 ADDRESS: Deaconess Medical Center West Campus, St. Louis, Missouri, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: A review of the anatomy, etiology, and conservative and surgical treatments of plantar fasciitis are presented and a simple surgical technique is introduced. The medial instep plantar fasciotomy was performed by the authors on 50 feet previously untreated by surgery (41 patients). The follow-up results (average length of time to follow-up was 11.3 months) revealed that 82.6% of the patients experienced at least 90% pain relief and 97.8% experienced at least 80% pain relief. Overall, 91.3% of the patients related at least 80% satisfaction with the results of the surgery and all but one of the patients stated that they would recommend and/or have the procedure performed again if the need arose. Complications arising from the instep procedure were limited, and the most frequent complaint was scar formation. Stress was placed on exhausting conservative measures before attempting surgical correction, and the average patient utilized five different modalities of conservative treatment over an average period of 13 months. Postoperatively, patients were encouraged to continue, or begin using, orthotics/arch supports to avoid problems such as arch pain. SOURCE: J Foot Ankle Surg 1995 Sep-Oct;34(5):447-57; discussion 509-10 55
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. ID: 96075447 TITLE: Scintigraphic localisation of steroid injection site in plantar fasciitis. AUTHOR: Dasgupta B; Bowles J ADDRESS: Southend Health Care Trust, Westcliff-on-Sea, Essex, UK. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng REGISTRY NUMBERS: 0 (Steroids) 63347-66-0 (Technetium Tc 99m Medronate)
ABSTRACT
: Plantar fasciitis is a common cause of heel pain. We evaluated scintigraphic localisation of the inflammatory focus in 15 patients with this condition. Technetium-labelled bone scans precisely localised abnormal discrete areas of tracer uptake in 12 (80%) of patients in the medial and posterior aspect below the inferior surface of the calcaneum. Steroid injection at the inflammatory site abolished local tenderness and reduced pain in all 12. Our findings support an injection approach through the medial heel border posterior to the point of heel tenderness. Technetium scintigraphy may be a useful investigation to localise the steroid injection site in resistant cases of plantar fasciitis. SOURCE: Lancet 1995 Nov 25;346(8987):1400-1 56
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. ID: 96027749 TITLE: Spur formation and heel pain [letter; comment] AUTHOR: Kelly A; Winson I; Wainwright A COMMENTS: Comment on: Clin Orthop 1994 Sep;(306):192-6 PUBLICATION TYPES: COMMENT LETTER LANGUAGE: Eng SOURCE: Clin Orthop 1995 Oct;(319):330 57
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. ID: 96023658 TITLE: A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome [see comments] AUTHOR: Tomczak RL; Haverstock BD COMMENTS: Comment in: J Foot Ankle Surg 1996 Mar-Apr;35(2):183-4 ADDRESS: College of Podiatric Medicine and Surgery, University of Osteopathic Medicine and Health Sciences, Des Moines, Iowa, USA. PUBLICATION TYPES: JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL LANGUAGE: Eng
ABSTRACT
: The authors review the etiologies and treatments
practitioner will be aided intraoperatively in determining what level of fasciotomy to perform. This could help obviate some of the postoperative biomechanical sequelae that can occur with total releases, and immediate postoperative excessive ambulation by the patient. This study may help to gain insight into the true etiology of heel spur syndrome/plantar fasciitis. SOURCE: J Foot Ankle Surg 1995 Jan-Feb;34(1):51-6 60
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. ID: 95299439 TITLE: The role of endoscopy in treatment of stenosing posterior tibial tenosynovitis. AUTHOR: Wertheimer SJ; Frascone ST; Calderone DR; Loder BG Weber CA ADDRESS: Department of Podiatric Surgery, St. John Hospital-Macomb Center, Harrison Township, Michigan, USA. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng
ABSTRACT
: Some foot and ankle pathologic conditions can be treated by an endoscopic approach. Its effectiveness has been reported in the treatment of plantar fasciitis. The authors have used an endoscopic approach in the treatment of posterior tibial tenosynovitis resistant to nonsurgical treatment. A review of the pathology, terminology and the diagnosis of tenosynovitis is provided. The case report demonstrates a technique using an endoscope to incise the posterior tibial tendon sheath. SOURCE: J Foot Ankle Surg 1995 Jan-Feb;34(1):15-22 61
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. ID: 95182390 TITLE: Heel spur surgery. Another new approach. AUTHOR: Licopantis DP ADDRESS: American Board of Podiatric Surgery, New City, NY. PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGE: Eng SOURCE: J Am Podiatr Med Assoc 1995 Feb;85(2):100-3
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. ID: 98232947 TITLE: Flexor hallucis longus dysfunction [In Process Citation] AUTHOR: Oloff LM; Schulhofer SD ADDRESS: Sports Orthopedic and Athletic Rehabilitation Medicine Group (SOAR), Menlo Park, CA 94025, USA. LANGUAGE: Eng
ABSTRACT
: Nineteen consecutive cases of flexor hallucis longus stenosing tenosynovitis that underwent operative tenolysis from September 1994 to December 1996 were retrospectively reviewed. This is classically a disorder of ballet dancers, and to a much lesser extent, running athletes. The patients were primarily nonathletic, male, and middle-aged. The mean symptom duration was 20 months, multiple physicians had been encountered, and misdiagnosis was common. Patients presented with overlapping signs and symptoms of flexor hallucis longus tendinitis, plantar fasciitis, and tarsal tunnel syndrome. A crossreference of patients with posteromedial ankle pain, medial arch pain, and/or a positive Tinel's sign revealed that 14 (74%) and 6 (32%) feet had two of three, or all three signs, respectively. Magnetic resonance imaging and tenography proved valuable in establishing the correct primary diagnosis. Nonoperative protocols were unsuccessful. Flexor hallucis longus tenolysis was successful in each case with a mean return to regular activity at 9 weeks. Flexor hallucis longus stenosing tenosynovitis may be more prevalent than reported and should be a diagnosis of inclusion among all patient populations who present with posterior ankle, medial arch, and/or tarsal tunnel symptoms. SOURCE: J Foot Ankle Surg 1998 Mar-Apr;37(2):101-9 3
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. ID: 98201985 TITLE: Differences in impulse distribution in patients with plantar fasciitis [In Process Citation] AUTHOR: Bedi HS; Love BR ADDRESS: Geelong Hospital, Victoria, Australia. LANGUAGE: Eng
ABSTRACT
: The impulse distribution based upon vertical foot-floor reaction forces and time under the fore-, mid-, and hindfoot was determined using Tekscan's F-Scan system. This was compared in 40 barefoot patients with long-standing plantar fasciitis with an equal number of normal subjects. The patient group tended to load the hind- and midfoot to a lesser extent than the control group. Consequently, a greater proportionate load was borne by the forefoot. This result was highly significant for both the midfoot (P < 0.001) and forefoot (P = 0.002) comparisons. An objective biomechanical method such as this may be useful a
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