Calcaneal decompression as part of painful heel syndrome  treatment

  • Saad Mubarak Rasheed Department of Surgery, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq.

Abstract

Background: Many modalities of surgical treatment are available for painful  heel syndrome  like: release of half of planter fascia, excision of spur, drilling  of calcaneum, and calcaneal osteotomy, without agreement on the most  effective one.  Aim: to evaluate the effect of calcaneal bone drilling in addition to planter  fascia release and calcaneal spur removal for patients with painful heel  syndrome.  Patients and methods: between 2007‐2011 at Al‐Yarmouk Teaching hospital,  a retrospective comparative study of (44) feet of (38) patients (M=11 and  F=27) with persistent painful heel syndrome divided into 2 groups: first group  (24)  feet  of  (18)  patients  were  treated  by  calcaneal  drilling  with  the  traditional surgery (release of planter fascia + calcaneal spur excision), and  the second group (20) feet of (20) patients were treated with traditional  surgery only (control group). Evaluation of patient's pain and satisfaction  was based on VAS (visual analogue pain scale) system for local pressure  tenderness and rest pain.  Results: The mean pre‐operative rest pain and local pressure tenderness  were 8.38±0.99 and 8.95±1.21 for group I respectively and 8.50±0.81and  8.80±0.81for group II respectively.There was significant decrease in rest heel  pain in group I in comparison with group II after 6 months (from 4.40±0.97  for group II to 0.88±1.05 for group I), and after 2 years follow‐up (from  2.25±1.47 for group II to 0.25±0.66 for group I) with p<0.05. There was  significant decrease in local pressure tenderness in group I in comparison  with  group  II  after  6  months  follow‐up  (from  5.85±1.01  for  group  II  to  1.92±1.58 for group I), and after 2 years follow‐up (from 3.85±1.56 for group  II to 0.33±0.75 for group I) with p<0.05. Complications were post‐operative  infection (9.1%), heel paresthesia (13.6%), and persistent pain (2.3%).  Conclusions: calcaneal drilling is one of significantly effective modality of  treatment for recurrent heel pain syndrome when combined with ordinary  release of planter fascia and spur excision. 

Published
2018-06-09
How to Cite
RASHEED, Saad Mubarak. Calcaneal decompression as part of painful heel syndrome  treatment. Mustansiriya Medical Journal, [S.l.], v. 13, n. 2, p. 5, june 2018. ISSN 2227-4081. Available at: <http://mmj.uomustansiriyah.edu.iq/index.php/MMJ/article/view/218>. Date accessed: 10 apr. 2020.