BackgroundPlantar fasciitis is a chronic degenerative process of the plantar fascia enthesis. It manifests by pain, predisposition to prolonged course and treatment resistance. In many cases, plantar fasciitis develops in patients with acquired flat feet. Taken into consideration above mentioned, the study of the plantar fascia changes in patients with acquired flat feet by sonography is relevant.ObjectivesTo investigate the quantitative and qualitative sonographic changes of the plantar fascia in the case of plantar fasciitis in patients with acquired flat foot.Methods190 patients with plantar fasciitis on the basis of acquired flat feet (133 females and 57 males). The average age of patients was 48 ± 0.97 years (18-81years). Unilateral pathology was noted in 117 patients and bilateral – in 73 patients. The average body mass index was 27.68±0.3. The average duration of pain syndrome was 101 ± 6.0 days (7-390 days). The pain syndrome lasted up from 1 to 6 months – in 152 patients, and more than 6 months – in 38 patients. The control group included 15 healthy volunteers (30 feet). Clinical radiological, sonographic, and statistical methods were used.ResultsThe main sonographic features were significant reduction in echogenicity, erased or missing fibrous pattern, fuzzy contour of the aponeurosis; and modified contour of the calcaneus; small focal hyperechogenicity points in enthesis were detected. Loci of vascularization were detected using power Doppler sonography. The average thickness of plantar fascia in the study group was 6,14±1,5 mm (2,3-7,7 mm) and in control group – 3,5±0,1 mm (2,5-4,4 mm).ConclusionSonographic signs of plantar fasciitis on the basis of acquired flat feet were changes in echogenicity and structure, changes in the contours of the cortical layer of enthesis and plantar fascia, the thickening of the enthesis of the plantar fascia of more than 4 mm.Disclosure of InterestsNone declared

BackgroundOsteochondral defects of the talus (ODT) is a relatively rare, mostly traumatic pathology, in 6.5 % of cases complicate the course of inversion and eversion injuries of the foot and ankle [1].ObjectivesTo conduct a clinical analysis of the effectiveness of autologous mosaic osteochondroplasty in the treatment of patients with osteochondral defects of the talus on the basis of determining the dynamics of pain and restoring the amplitude of ankle movements.MethodsThe study included 34 patients with post-traumatic osteochondral defects of the talus (27 men, 7 women, mean age 24.8 ± 2.1 years) who underwent osteochondroplasty. The duration of painful clinical symptoms before osteochondroplasty ranged from 4 to 18 months. Functional treatment outcomes were assessed over a period of 12 to 36 months using the International Foot and Ankle Surgery Scale (AOFAS), pain dynamics were assessed using the Visual Analog Scale (VAS), and ankle movement recovery dynamics were determined.ResultsOsteochondral autologic grafts were removed from the lateral condyle of the ipsilateral femur. Defect sizes: square from 82 to 129 mm2 (110,3 ± 0.8 mm2), depth from 7 to 16 mm (12 ± 0,8 mm). Incorporation of the graft in the recipient bed occurred within 1,5 – 3 months. Long-term follow-up was 12 – 36 months (22,8 ± 3,8 months). The level of pain was decreased from 5,7 ± 0,3 before to 0,9 ± 0,3 after the operation (p < 0.001; paired t-test). Improving of foot function according to AOFAS scale (hindfoot section) was established from 64,9 ± 1,4 to 95,9 ± 1,1 (p < 0.001; paired t-test). Extension increasing from 15,0 ± 0,9 to 18,4 ± 0,7 and flexion increasing from 22,9 ± 1,2 to 30,7 ± 1,1 was registered. There were no cases of implants failure or their instability neither the increasing of degenerative changes in the ankle joint.ConclusionOsteochondroplasty is the effective method of congruity restoration in cases of post-traumatic talus osteochondral defects, promotes a significant reduction in pain syndrome and an improvement in the function of the ankle. The unknown mechanism of the analgesic effect of osteochondroplasty requires further research.References[1]O’Loughlin PF, Heyworth BE, Kennedy JG. Current concepts in the diagnosis and treatment of osteochondral lesions of the ankle. Am J Sports Med. 2010;38:392-404. doi: 10.1177/0363546509336336.Disclosure of InterestsNone declared