Abstract
We describe a comprehensive approach to the endoscopic treatment of calcaneal spur
syndrome developed by the Arthroscopic Group of the Orthopedic Service of Hospital
Hermanos Ameijeiras in Havana, Cuba. The surgical technique involves treatment of
the heel spur and plantar fasciitis commonly found in calcaneal spur syndrome, but
it also addresses adjacent calcaneal periostitis and allows decompression of the nerve
to the abductor digiti quinti. Medial endoscopy and lateral instrumentation are used
in a sequential approach with exposure and debridement of the posterior roof of the
calcaneal arch, followed by removal of the calcaneal spur, lateral to medial release
of the medial 75% of the plantar fascia, and if necessary, debridement of the calcaneal
tuberosity periosteum. This technique was used in a prospective case series from June
1997 to May 1998 to treat a select group of 38 feet in 30 patients who reported unacceptable
levels of pain despite 5 months of conservative treatment, which included an aggressive
8-week physical therapy program prescribed by the treating physician. Good to excellent
results were obtained at 3 months postoperatively in all patients with regard to pain
relief and return to normal activity, although 5 patients required a short course
of physical therapy to resolve symptoms brought on by sports, trauma, or impact loading
before 1-year follow-up, at which time all patients reported good to excellent results.
Complications included 3 superficial wound infections cured by oral antibiotics and
2 transient lateral paresthesias that resolved with rest and nonsteroidal inflammatory
medications. The described technique may provide a useful method for treating refractory
heel spur syndrome and warrants further study.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 5 (May-June),
2001: pp 517–522
Keywords
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Article info
Footnotes
*Address correspondence and reprint requests to Todd B. Guthrie, M.D., Park Ridge Orthopedics P.A., 27 Doctor’s Dr, Fletcher, NC 28732, U.S.A. E-mail: [email protected]
Identification
Copyright
© 2001 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
