Introduction
Plantar fasciitis is the most common cause of chronic heel pain with high discomfort up to being unable to bear weight on the heel. Several factors may contribute to plantar fasciitis, including rheumatic disorders, gouty arthritis, peripheral neuropathies, nerve entrapment, and local foot deformities such as pes planus. However, a large group of patients have idiopathic plantar fasciitis with no detectable cause. Plantar fasciotomy is currently the most common surgical treatment refractory fasciitis. Increasingly, surgeons are adopting an endoscopic approach to plantar fascial release to avoid the complications associated with the open procedure.
Patients and methods
A total of 32 patients with resistant plantar fasciitis preoperatively and after a 26 months followup time were examined. The endoscopic procedure was performed in all patients using medial and lateral portals. All patients were clinically assessed preoperatively and postoperatively with respect to the level of pain, function, gait, range of motion, and patient satisfaction to drive the modified American Orthopaedic Foot and Ankle Society (AOFAS) score.
Results
At the end of the follow-up period (AOFAS), ankle-hindfoot mean score improved significantly to 92.36 ± 5.2 points (range, 69–98 points, = 0.0001). Twelve (37.5%) patients had excellent results, 16 (50%) patients had good results, two (6.25%) patients had fair results, and two (6.25%) patients had poor results.
Conclusion
Endoscopic plantar fascial release with calcaneal spur decompression (if present) is a minimal invasive, reliable technique and could be a viable alternative to more invasive procedures for management of resistant plantar fasciitis.