Surgical Treatment for Chronic Plantar Fasciiits: The Endoscopic Plantar Fasciotomy

Heel pain is most commonly caused by a condition called plantar fasciitis. 

Plantar fasciitis may or may not involve a spur. The plantar fascia becomes thickened at the site of attachment onto the calcaneus. Patient’s experience pain with weight bearing after rest, prolonged standing and exercise. 

 

Fortunately, ~90% of patients with plantar fasciitis will respond to conservative treatment. Conservative treatment options include rest, taping, stretching, medications, shoe gear changes, physical therapy, steroid injections, shockwave treatments and orthotics. More aggressive treatments are indicated only if conservative treatment options fail. 

 

The endoscopic plantar fasciotomy is a minimally invasive and minimally traumatic surgical option to permanently correct this condition. The procedure is done as an outpatient. The procedure is performed through a small incision at the inside of the heel. A cutting device releases a portion of the fascia. The surgeon utilizes a small tube and camera for direct visualization of the fascia.  This procedure allows patients to return to regular activities sooner and with less pain. 

 

After surgery the foot will be immobilized with limited weigh bearing for ~4 weeks.  Physical therapy is normally a part of the recovery process. Postoperative complications can occur and this needs to be discussed with your surgeon prior to surgery. If you have failed conservative treatment for plantar fasciitis this surgical option may be an appropriate choice. 

 

  • Kirchens, FACFAS
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