Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleEndoscopic Plantar Fascia Release*,**
Section snippets
ANATOMY
We dissected 6 anatomic specimens to clearly define the landmarks for transection of the plantar fascia and to observe the neurovascular structures for safety. The point of division of the plantar fascia is approximately 1 cm distal from its attachment at the medial tuberosity of the calcaneus. The plantar fascia is divided from superficial to deep as described by Barrett and Day.3, 4
We found that a reliable portal could be established medially using the posterior bony ridge of the medial
SURGICAL TECHNIQUE
We used a technique similar to that described by Barrett and Day.3, 4 Some patients were given a general anesthetic and a tourniquet was used. In others we used a foot block and elastic escmark bandage around the ankle for hemostasis. All procedures were performed in an outpatient setting.
The medial portal was established along a line referencing the posterior border of the medial malleolus. The extension of this line to the sole of the foot marks the site of the portal (Figure 3, Figure 4,
RESULTS
Fifty-five consecutive patients were studied; there was complete information on 53. Twelve cases were bilateral, so there were 65 feet in all. All met the preoperative selection criteria outlined above. They were assessed preoperatively and postoperatively based on the criteria of pain at rest, morning stiffness, pain with activities of daily living, pain with sports, and resumption of sporting activities. The results were analyzed statistically using the null hypothesis that there would be no
DISCUSSION
Plantar fasciitis was known as “policeman's heel.” The British origin of the term described policemen wearing ill-fitting shoes and chasing criminals on foot. Although the term is not used commonly today, it describes well the forces that predispose healthy individuals to plantar fasciitis. These people participate in weight-bearing activities with repetitive impact such as joggers, tennis players, and ballet dancers.7 Individuals who wear improper shoes, run on their toes, on soft terrain, or
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Cited by (34)
Effects and risks of performing a single incision endoscopic plantar fasciotomy — An anatomical study
2022, Foot and Ankle SurgeryCitation Excerpt :In none of the specimens of both groups any of the major vascular (MPA, LPA) or nervous structures (MPN, LPN, BN) has been damaged. These results as well as the anatomical quantifications are in line with previous studies evaluating dual incision fasciotomy [11,13]. The abductor hallucis muscle was damaged superficially in four specimens (10%).
Endoscopic plantar fasciotomy for plantar fasciitis: A systematic review and network meta-analysis of the English literature
2019, FootCitation Excerpt :Most of the studies included in our systematic review performed a partial endoscopic plantar fasciotomy. Only Ogilvie-Harris [23] performed a complete plantar fascia release. Complete release biomechanically risks causing a loss of the windlass effect in the foot, subsequent decrease in arch height and increased strains on the plantar ligaments and increased stress and pain in the midfoot [11,29].
Percutaneous Plantar Fascia Release With Needle: Anatomic Evaluation with Cadaveric Specimens
2019, Journal of Foot and Ankle SurgeryUltrasound-Assisted Endoscopic Partial Plantar Fascia Release
2013, Arthroscopy TechniquesCitation Excerpt :We do not allow the patients to perform high-impact activities such as running for at least 2 months, and athletes participate in a sports-specific training program before returning to sports. Complication rates after EPFR have been reported to range from 3% to 10%.1,16,17 Although neurologic complication rates are not very high, there is the risk of nerve damage by introducing the arthroscopic cannula deep to the plantar fascia and it has been reported previously by various authors.16,18,19
Subcalcaneal bursitis with plantar fasciitis treated by arthroscopy
2013, Arthroscopy TechniquesCitation Excerpt :Recently, an arthroscopic technique for plantar fascia release has gained popularity and has been shown to be effective in cases in which there is no need for Baxter nerve decompression.11-15 The arthroscopic approach for the plantar fascia includes either a superficial fascial dry technique (without arthroscopic fluid lavage), by use of a slotted or transparent cannula similar to the arthroscopic carpal tunnel release (the arthroscope is located between the skin and the fascia),11-13 or a deep fascial technique with arthroscopic fluid lavage (the arthroscope is located deep in the fascia).14,15 Komatsu et al.15 reported that the deep fascial approach for plantar fasciitis allows a wide visual field and working space.
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Address correspondence and reprint requests to D. J. Ogilvie-Harris, F.R.C.S.C., Toronto Western Hospital, Edith Cavell Wing 1-032, 399 Bathurst St, Toronto, Ontario M5T 2S8, Canada.
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