Background: Heel pain with or without calcaneal spur is a challenging problem. Once conservative measures have failed,
surgery may be indicated; there has been debate about the best surgical procedure. Two standard operative procedures
have been either releasing the plantar fascia or removing the spur with drilling of the calcaneus. In this study, we evaluated
the results of percutaneous drilling of the calcaneus combined with mid-sole release of the plantar fascia for treatment of
resistant heel pain.
Methods: This study included 20 cases with resistant heel pain after failure of conservative measures for 6 months.
Clinical, radiological evaluation and scoring patients’ conditions according to the American Orthopedic Foot and Ankle
Society (AOFAS) Ankle-Hindfoot scale was done preoperatively and postoperatively. Percutaneous drilling of the calcaneus
combined with mid-sole release of the plantar fascia was done in all cases, and the functional results were evaluated
through the follow-up period that extended from 9 to 16 months with a mean duration of 12 ± 2.3 months.
Results: There was statistically significant improvement in the mean AOFAS Ankle-Hindfoot scale score from 50.8 ± 7.5
preoperatively to 91.6 ± 7 postoperatively at the last follow-up. There were no surgery-related complications, and the
mean time for full recovery was 8 ± 3.7 weeks with no recurrence of pain by the last follow-up.
Conclusions: The results were very satisfactory with using this minimally invasive and simple technique for treatment for
resistant heel pain.
Level of Evidence: Level IV, retrospective case series. |
