Point-Counterpoint: Recalcitrant Plantar Fasciitis: Is Fasciotomy Ever Necessary?

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Author(s): 
Stephen L. Barrett, DPM, MBA, and Kevin A. Kirby, DPM

   Dr. Barrett is an Adjunct Professor within the Arizona Podiatric Medicine Program at the Midwestern University College of Health Sciences. He is a Fellow of the American College of Foot and Ankle Surgeons.

References

1. Barrett SL, Erredge SE. Growth factors for chronic plantar fasciitis. Podiatry Today. 2004; 17(11):37-42.
2. Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003; 93(3):234-237.
3. Barrett SL, Woolley M. Partial plantar fasciectomy with autologous platelet concentrate. Practical Pain Management. November/December 2010. Available at http://bit.ly/nnLrUp .
4. Barrett SL, Day SV. Endoscopic plantar fasciotomy vs. traditional heel spur surgery. J Foot Ankle Surg. 1994; 33(2):214-216.
5. Barrett SL, Day SV, Brown MG. Endoscopic plantar fasciotomy: preliminary study with cadaveric specimens. J Foot Surg. 1991; 30(2):170-172.
6. Barrett SL, Day SV, Pignetti TT, Robinson LB. Endoscopic plantar fasciotomy: a multi-surgeon prospective analysis of 652 cases. J Foot Ankle Surg. 1995; 34(4):400-406.
7. Cardinal E, Chhem RK, Beauregard CG, Aubin B, Pelletier M. Plantar fasciitis: sonographic evaluation. Radiology. 1996; 201(1):257-259.
8. Gibbon WW, Long G. Ultrasound of the plantar aponeurosis (fascia). Skeletal Radiol. 1999; 28(1):21-26.
9. Kamel M, Kotob H. High frequency ultrasonographic findings in plantar fasciitis and assessment of local steroid injection. J Rheumatol. 2000; 27(9):2139-2141.
10. Kane D, FitzGerald O. Re: The role of ultrasonography in the diagnosis and management of idiopathic plantar fasciitis. Rheumatology (Oxford). 2003; 42(3):486.
11. Kane D, Greaney T, Shanahan M, Duffy G, Bresnihan B, Gibney R, FitzGerald O. The role of ultrasonography in the diagnosis and management of idiopathic plantar fasciitis. Rheumatology (Oxford). 2001; 40(9):1002-1008.
12. Barrett SL. Endoscopic plantar fasciotomy--surgical technique. Tech Foot Ankle Surg. 2011; 10(2):56-64.
13. Rose JD, Malay DS, Sorrento DL. Neurosensory testing of the medial calcaneal and medial plantar nerves in patients with plantar heel pain. J Foot Ankle Surg. 2003; 42(4):173-177.
14. Chang CW, Wang YC, Hou WH, Lee XX, Chang KF. Medial calcaneal neuropathy is associated with plantar fasciitis. Clin Neurophysiol. 2007; 118(1):119-123.
15. Dellon AL. Deciding when heel pain is of neural origin. J Foot Ankle Surg. 2001; 40(5):341-345.
16. Dellon AL. Technique for determining when plantar heel pain can be neural in origin. Microsurgery. 2008; 28(6):403-406.
17. Barrett SL, Day SV, Brown MG. Endoscopic plantar fasciotomy: preliminary study with cadaveric specimens. 1991. J Foot Ankle Surg. 2011; 50(4):439-440.
18. Kinley S, Frascone S, Calderone D, Wertheimer SJ, Squire MA, Wiseman FA. Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study. J Foot Ankle Surg. 1993; 32(6):595-603.
19. Urovitz EP, Birk-Urovitz A, Birk-Urovitz E. Endoscopic plantar fasciotomy in the treatment of chronic heel pain. Can J Surg. 2008; 51(4):281-283.
20. Tomczak RL, Haverstock BD. A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J Foot Ankle Surg. 1995; 34(3):305-311.

   For further reading, see “Should You Change Your Approach To Plantar Fasciosis?” in the November 2006 issue of Podiatry Today.

   Dr. Barrett also writes a blog for Podiatry Today. For recent blogs, visit http://bit.ly/oAfxza .

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robert bijak,dpmsays: November 7, 2011 at 5:54 pm

Who cares if you cause " negative biomechaincal alterations" as long as it takes the patients' pain away? Most people do very well with fasciotomy so apparently all the biomechanical theory is just that.

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