INTRODUCTION: After reconstructive forefoot surgery, patients require complete or partial forefoot relief, which can be obtained with a variety of shoe designs.

AIM: to review our experience with the use of the heel bearing shoes for forefoot weight relief and evaluate its use & application in our daily forefoot surgical practice

METHOD: A retrospective review of all (341) patients who underwent reconstructive forefoot surgery in our unit during the period of January 2003 to October 2007.

RESULTS: All patients used Barouk heel bearing shoes in the post operative period 283(83%) were females and 58(17%) were males. Average age was 56 years (range 14–84). In March 2006 we changed our postoperative protocol with the introduction of early physiotherapy for the lesser toes. 258 procedures performed between January 2003 to February 2006 (first group), while 83 procedures performed March 2006 to October 2007 (second group).

51(19.77%) from the first group reported stiffness of toes at 6 weeks review whilst only 3(3.61%) out of the second group.18 (6.98%) reported discomfort and stiffness of the hip from the first group in comparison to only 2(2.25%) patients in group two. From the first group 27(10.47%) reported knee stiffness while only one patient in the second group. The incidence of clinically significant low back pain was 12(4.65%) in the first group and 5(5.61%) patients in the second group.

CONCLUSION: heel weight bearing shoes play an important role following reconstructive forefoot surgery; however some problems may be encountered during their use. Early physiotherapy is essential to avoid these problems.

Purpose of study: Study and prove the benefits and efficacy of the use of extracorporeal shockwave therapy (ESWT)for the treatment of planter fasciitis.

Introduction: Planter fasciitis is the second most common cause of heel pain. Conservative treatment modalities for the treatment of planter fasciitis includes NSAIDS, heel cushions, ultrasound, physiotherapy, injections, etc and these often do not offer satisfactory results. We present the results of the use of ESWT in the treatment of planter fasciitis with good results.

Methodology: 129 patients, 77 males and 52 females with a 152 heels were treated with ESWT from July 2002 until August 2004 and were included in the study. The average age was 53.2 years (Range 28 to 83 years). All patients had previously undergone other conservative forms of treatment with poor results. Inclusion criteria included age greater than 18 years, male or female, no previous history of surgery on the heel or foot, visual analogue score of over 5 for pain. Treatment was done on an outpatients basis. Each patient received between minimum of one and maximum of three sessions of ESWT at two weeks interval.

Results: 116 patients, 69 males and 47 females with 136 heels were reviewed with 13 patients with 16 heels lost to followup. 52 patients (44.8%) with 60 heels (44.1%) had excellent results. 45 patients (38.8%) with 53 heels (38.0%) had good results. 13 patients (11.2%) with 16 heels (11.8%) had fair results. 6 patients (5.2%) with 7 heels (5.1%) had poor results. Overall 104 patients (89.7%) with a 121 heels (89.0%) considered the outcome to be successful.

Conclusion: Based on our results, we recommend ESWT fot the treatment of planter fasciitis especially in patients with failed other forms of conservative treatment and as an alternative to surgery with good results.