Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2008; 75(5):363-368 | DOI: 10.55095/achot2008/065

Artroskopická léčba syndromu plantární ostruhyPůvodní práce

S. STROPEK^*, M. DVOŘÁK

Ortopedicko-traumatologické oddělení Nemocnice Jindřichův Hradec, a. s.

PURPOSE OF THE STUDY:
Arthroscopic treatment of calcaneal spur syndrome is a tissue-sparing and effective approach when conservative therapy has failed. This method, its results and our experience with the treatment of this syndrome are presented here.

MATERIAL:
Between January 2003 and November 2007, 26 patients underwent an arthroscopic procedure for calcaneal spur syndrome; of these, 20 were women with an average age of 49 years, and six were men with an average age of 45 years. Four, three women and one man, were lost to follow-up, therefore 22 patients with 24 heels were eventually evaluated. All had conservative therapy for 3 to 6 monts.

METHODS:
The arthroscopic method used was developed by the arthroscopic group of the Orthopaedic Service of Hospital Hermanos Ameijeiras in Havana, Cuba. The surgical technique insolves treatment of the spur and plantar fasciitis commonly found in calcaneal spur syndrome, but it also addresses adjacent calcaneal periostitis.

RESULTS:
The results were evaluated on the scale that is part of the foot function index developed by Budiman-Mak for measuring rheumatoid arthritis pain. The patients were asked mine questions on pain intensity during various activities before and after surgery. Pain was evaluated on a scale with grades from 0 to 9. The average value was 5.9 before surgery and 1.4 after surgery. A 0-1 pain range was reported by 25 %, 1-2 by 26 % and 2-4 by 22 % of the patients. All patients reported improvement.

DISCUSSION:
The orthopaedic group in Havana led by Carlos achieved 85 % excellent outcomes (pain range, 0-2) at one-year follow-up; this was 79 % in our study, in which no problems with foot arches or wound infection were recorded.

CONCLUSIONS:
The heel spur syndrome is a result of an inflamed ligament (plantar fascia) due to repeated microtrauma. It is not a traction osteophyte,but a reaction of the tissue where it attaches to the calcaneus. Adjacent calcaneal periostitis is usually present as well. Therefore, this method treting all three causes of the syndrome appears to be more effective than mere fasciotomy.

Klíčová slova: calcaneal spur syndrome, plantar fasciitis, heel spur, periostitis, microtrauma

Přijato: 24. červen 2008; Zveřejněno: 1. říjen 2008  Zobrazit citaci