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Endoscopic Deep-Fascial Approach for the Treatment of Plantar Fasciitis

Ahmed Hashem Amin and Mohamed Hamed Fahmy

Study design: Retrospective study.

Objective of the study: The purpose of this study was to determine the clinical results of deep-fascial medial and lateral portals in performing endoscopic surgery for plantar fasciitis.

Background: plantar fasciitis is the most common injury of the plantar fascia, 90% of cases respond to conservative treatment and 10% needs surgical treatment.

Methods: We treated seven patients who complained from plantar fasciitis by endoscopic surgical release of the plantar fascia using the deep-fascial approach after failure of conservative treatment for more than 6 months. They were 4 male and 3 female patients with a mean age at surgery of 36 years (range, 22-55 years). A heel spur was detected in 5 patients and it was resected to establish a clear view of the plantar fascia.

Results: The mean American Orthopedics Foot and Ankle Society Ankle Hindfoot Scale (AOFAS) score was 64 points before surgery and 90 points at 2 years after surgery. In the categories of the AOFAS score, pain was improved significantly: 16.0 points before surgery and 38 points at 2 year after surgery. Six patients returned back to full preoperative activity by a mean of 7 weeks (Range, 6 to 8 weeks).

Conclusions: Endoscopic surgery for the treatment of plantar fasciitis through a deep-fascial approach allows for adequate working space, better visualization of the surgical field, precise cutting of the medial half of the plantar fascia, excision of the calcaneal spur and provide better clinical results than the slotted cannula methods.