This 24-year-old male presented at my rooms with an 8-year history of bilateral “plantar fasciitis”. He had been treated with various modalities and health practitioners over the years, including 4 steroid injections in each heel and was actually wearing a CAM/moon boot on his right foot.
The patient presented with radiographs and ultrasounds with a diagnosis of plantar fasciitis. It is imperative to understand that, at this chronic stage, it would actually be plantar fasciOSIS and not fasciITIS. The subtle difference in nomenclature and hence diagnosis is essential, as this will lead us down a more correct pathway, as the origin of the fascia is now degenerating and “stagnant” and not actually inflamed as “itis” suggests.
Please see the image of the ultrasound and note the thickened and heterogenic plantar fascia origin between the two crosses.
Baxter’s nerve entrapment was assessed and was NOT present and hence he was offered minimally invasive plantar fascial release to take the traction away from the origin to allow healing. This was done in conjunction with platelet-rich plasma injection directly into the thickened tissue after the wounds were sutured. Please see the 2 small incisions utilised to lengthen/release the medial and central bands on the image. This has very quick recuperation and evidence-based medicine shows this produces excellent results.
If you have any specific questions or would like to discuss similar cases, feel free to contact me.
Plantar fasciotomy post-op
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