Introduction: Plantar fasciitis is a common syndrome characterized by pain at the origin of the plantar fascia, most often on rising after a period of inactivity. It is usually self limited. Treatment includes: NSAIDs, physical therapy, orthotics, steroid injections, and lately shock wave therapy. Patients who fail to respond to non-operative treatment are often referred to one of a variety of surgical procedures.
We report our experience with one such procedure, percutaneous release via a medial approach.
Methods: At our institution, patients with plantar fasciitis who fail to improve despite first (NSAID, PT) and second (injection, orthotics) line therapy, are referred for percutaneuos plantar fasciotomy. We retrospectively reviewed 34 patients who underwent 38 procedures between 1999–2006. Mean patient age at surgery was 50 (30–65). 24 were evaluated by an uninvolved orthopedic surgeon at an outpatient clinic, and 10 responded to a mail or telephone questionnaire. Assessment included pain relief, functional improvement, complications, and willingness to re-undergo, or recommend the surgery.
Results: Average VAS score dropped from 8.9 to 2.1. Function improved in 93%. The surgery met or exceeded expectations in 76%, and 82% would have re-undergone or recommended the procedure. Injury to the lateral plantar nerve was encountered in 3 patients.
Conclusion: Percutaneous plantar release is an effective treatment for resistant plantar fasciitis. Care should be taken to prevent nerve injury by accurate technique.
