Plantar fasciitis : a new line of management

الملخص EN

Objective: The aim was to assess the value of ultrasonography in the diagnosis of proximal plantar fasciitis (PF) and to evaluate the safety and early preliminary efficacy of the Extracorporeal Shock Wave Therapy (ESWT) in the management of non-responsive cases to conservative treatment.

Materials and Methods: Sixty-four patients with a clinical diagnosis of idiopathic proximal PF in 78 heels underwent Ultrasound (US) examination of both heels at baseline.

The values were compared to asymptomatic heels in unilateral cases (control I) and to both heels of 15, age and sex matched, asymptomatic volunteers (control II).

Clinical assessment was done according to Visual Analogue Scale (VAS) and Tenderness Threshold (TT).

Patients who experienced non-successful conservative therapy for more than 6 months underwent ESWT using the Ossatron.

Re-assessment clinically and ultrasonographically were done to symptomatic heels 6 weeks after treatment.

Results: The mean thickness of the plantar fascia as measured with US was 4.95+1.16 mm in symptomatic heels as compared with 2.51+0.54 mm in asymptomatic heels and 2.32+0.41 mm in control II.

The difference between the symptomatic heels and both control groups was statistically significant.

The proximal plantar fascia of symptomatic heels was diffusely hypoechoic in 84.6%.

There were improvements clinically and ultrasonographically 6 weeks after ESWT.

Conclusion: US examination of plantar fascia is easy, quick, sensitive, non-invasive and inexpensive to perform.

It should be considered early in the diagnosis and management of PF.

The Ossatron is a safe, effective and non-invasive method of treating chronic PF that has been unresponsive to conservative treatment and it may be an alternative option for operation.