Summary

To investigate the association between plantar fasciitis and calcaneal spur and make a classification.

Abstract

Purpose

To investigate the association between plantar fasciitis and calcaneal spur and make a classification. Methods: 30 cases /38 feet with idiopathic painful plantar fasciitis and calcaneal spur, all of whom failed conservative treatment for 6 months at least, underwent endoscopic plantar fasciectomy and calcaneal removal. The plantar fasciitis with calcaneal spur were classified into type A: 21 feet and type B: 17 feet, which were based on the arthroscopy. Type A: the calcaneal spur is over the plantar fasciitis. Type B: the calcaneal spur is inserted in the plantar fasciitis. All patients were followed up at 3, 6, 9, 12 months and then every 6 months with visual analog scale scores (VAS) for evaluation of pain and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores for functional evaluation and radiographic measurement. Results: All patients were satisfied with clinical results without pain 3 months postoperatively. The mean VAS and AOFAS ankle-hindfoot score improved from 8.3( 2.7) scores, 55( 3.67)scores preoperatively to 1.4( 0.8) scores, 85( 7.8) scores at the last follow-up (p<0.05) in type A group and 7.9( 2.3) scores, 60( 3.82)scores preoperatively to 1.9( 0.8) scores, 80( 7.8) scores. Calcaneal spur was removed totally after surgery and did not reoccur at last follow-up by radiographic assessment. The satisfaction rate was 85% without major complication. Conclusion:Endoscopic plantar fascia debridement with calcaneal spur removal has high success rate for two types but the classification shows type A is predisposed to plantar fasciitis.
Key words: Endoscopy, Plantar Fascia, Debridement, Calcaneal Spur, Heel Pain