Bruce D. Gorlick, D.P.M., FACFAS    

             

HONcode accreditation seal. We comply with the HONcode standard for health trust worthy information:
verify here. HONConduct252698

                                     

                        

   Home
News
New Patient Form
Foot & Ankle Conditions
Pain Disorder/RSD
Surgical Reconstruction
5 Most Unwanted
ACFAS Annual Meeting.htm
Worker's Compensation
Privacy Policy
Sacramento
Legal Notice
Feedback

 

 

 

 

 

 

 

 

 

 

 

 

  The process of plantar fascia tissue change typically occurs as a consequence of protracted mechanical overuse.  Mechanical overuse may occur by excessive stress, which would include increased body mass index (BMI), pathobiomechanics, contact sensitization due to irresilient and uneven environmental surfaces and excessive weight bearing activities.  Such tissue changes are also prevalent in certain instances associated with non-specific fasciitis syndromes.

Surgical treatment of plantar fasciitis or heel spur syndrome is indicated only after conservative measures have failed. Conservative management includes corticosteroid injections, orthotic therapy, orthopaedic taping and padding, physical therapy, iontophoresis, stretching and/or flexibility programs, rest, immobilisation (below knee casts), non-steroidal anti-inflammatory drugs, and cessation of activity (Bordelon, 1993; Jacoby and Wolfe, 1991; Sammarco and Helfrey, 1996; and Stone and Davies, 1996).According to Gill and Kiebzak (1996) casting was the best conservative treatment method. Studies examined by Brekke and Green (1998) and Bordelon (1993) observe approximately 90% of cases exhibit total relief with conservative treatment alone

Acute rupture of the plantar fascia would require an extraordinary mechanical event.  Review of the podiatric literature indicates that this is a rarely reported condition. Pai (1996) published a case report of a degenerative/non-traumatic plantar fascia rupture which occurred and was implicated with multiple cortisone injections for plantar fasciitis[1]  This is the only non-traumatically caused case I could find in the podiatric literature.  Rolfe et. al (1997) reported two traumatic cases[2], Christel et. al. (1993) reported 18 traumatic cases, 17 occurring in the competitive athlete[3] and the largest series reported is 30 cases (Poux, D., Christel, P., Demarais, Y., Parier, J., Roger, B., Viel, E. Les ruptures de láponevrose plantaire. J.  Traumatol. Sport 6:77-87, 1989 as discussed in Christel.)   The definitive specialized diagnostic study to evaluate for plantar fascia rupture is MR.

[1] Pai, VS, Rupture of the Plantar Fascia, J. Foot and Ankle Surg., 1996, V35 N1, pg. 39

[2] Rolfe, C et. al., Plantar Fascia Rupture: Diagnosis and Treatment, J. Foot and Ankle Surg., 1997, V36 N2, pgs 112-114.

[3] Christel, P., Rigal, F., Poux, D., Roger, B., Witvoet, J.  Surgical treatment of rupture of the plantar fascia. Rev. Chir. Orthop. 79:218-225, 1993

 

   

[Surgical Reconstructive Procedures] [Podiatric Conditions] [Disclaimer]    Hit Counter Since Aug. 10, 2003

Send mail to webmaster c/o medmedia@podiatryclinician.com with questions or comments about this web site.
Last modified: 12/19/06