Consequences of Partial and Total Plantar Fascia Release: A Finite Element Study

Cheung, Jason Tak-Man; An, Kai Nan; Zhang, Ming

doi:10.1177/107110070602700210

Cited by 105 publications

(61 citation statements)

References 21 publications

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“…FE models have been widely used to quantify the biomechanical role of the plantar fascia in load bearing, and vertical displacement of the foot was found to increase with fasciotomy [10,11]. 3-D geometrical detailed FE models have also been developed [14][15][16][17][18][19], although those studies did not quantify the biomechanical role of the plantar fascia to the tarsal and metatarsal bone simultaneously, and did not examine the one-foot standing posture, which is important to support the body weight in walking. Based on both anatomy and computer software, we established a detailed FE model of a normal adult left foot that included the bone segments, articulations, foot intrinsic ligaments, and plantar soft tissue.…”

Section: Discussionmentioning

confidence: 99%

Deformation and stress distribution of the human foot after plantar ligaments release: A cadaveric study and finite element analysis

Liang

Yang

et al. 2011

Sci. China Life Sci.

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The majority of foot deformities are related to arch collapse or instability, especially the longitudinal arch. Although the relationship between the plantar fascia and arch height has been previously investigated, the stress distribution remains unclear. The aim of this study was to explore the role of the plantar ligaments in foot arch biomechanics. We constructed a geometrical detailed three-dimensional (3-D) finite element (FE) model of the human foot and ankle from computer tomography images. The model comprised the majority of joints in the foot as well as bone segments, major ligaments, and plantar soft tissue. Release of the plantar fascia and other ligaments was simulated to evaluate the corresponding biomechanical effects on load distribution of the bony and ligamentous structures. These intrinsic ligaments of the foot arch were sectioned to simulate different pathologic situations of injury to the plantar ligaments, and to explore bone segment displacement and stress distribution. The validity of the 3-D FE model was verified by comparing results with experimentally measured data via the displacement and von Mise stress of each bone segment. Plantar fascia release decreased arch height, but did not cause total collapse of the foot arch. The longitudinal foot arch was lost when all the four major plantar ligaments were sectioned simultaneously. Plantar fascia release was compromised by increased strain applied to the plantar ligaments and intensified stress in the midfoot and metatarsal bones. Load redistribution among the centralized metatarsal bones and focal stress relief at the calcaneal insertion were predicted. The 3-D FE model indicated that plantar fascia release may provide relief of focal stress and associated heel pain. However, these operative procedures may pose a risk to arch stability and clinically may produce dorsolateral midfoot pain. The initial strategy for treating plantar fasciitis should be non-operative. The plantar fascia, or plantar aponeurosis, is the investing fascial layer of the plantar aspect of the foot, and forms part of the retinacular system, consisting of a network of connective and adipose tissues that supports and protects underlying vital structures of the body. The anatomy of the plantar fascia has been well described by Sarrafian [1] and others [2][3][4][5]. Partial or total plantar fascia release may relieve metatarsal and calcaneal stresses and painful heel syndromes of plantar fasciitis. However, reduction of plantar fascia stiffness may have a significant impact on arch stability, resulting in a more deformable longitudinal arch. Cadaveric studies have been performed to examine biomechanical consequences of release of the plantar ligaments. Huang [6] reported that the average vertical displacements

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Section: Discussionmentioning

confidence: 99%

Deformation and stress distribution of the human foot after plantar ligaments release: A cadaveric study and finite element analysis

Liang

Yang

et al. 2011

Sci. China Life Sci.

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“…La tenotomía percutánea da buenos o excelentes resultados tras 18 meses en el 75% de los casos 55 . Cabe decir que aunque los resultados evidencian una mejora de los síntomas en el 80% de los casos, existen complicaciones que limitan la elección de esta opción terapeú-tica, tales como largos tiempos de recuperación post-quirúrgicos (en el 67% de los casos los pacientes retoman su actividad física normal 14 ), restricción del movimiento, riesgo de ruptura de la fascia por el lugar de la liberación con el consiguiente colapso del arco, estrés excesivo de los ligamentos cercanos e incremento de la presión medial (según los autores) 17,53,54 , hechos que pueden influir a la hora de elegirla como opción terapéutica para fascitis y tendinitis. Algunos estudios defienden la liberación del paraténon como tratamiento idóneo para aliviar el dolor de las tendinopatías aquíleas, ya que en ellas es típica la proliferación nerviosa del paraténon hacia el tendón de Aquiles y por tanto se produce una liberación masiva de sustancias nociceptivas.…”

Section: Faseunclassified

Uso de la microtenotomía por radiofrecuencia con el dispositivo Topaz® para el tratamiento de la tendinopatía aquílea no insercional

Gómez

Capapé²,

López‐López

et al. 2013

Rev. Int. Cienc. Podol.

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Los autores declaran no tener ningún tipo de interés económico o comercial. ReSuMenLas lesiones del tendón de Aquiles son un motivo frecuente de consulta en el ámbito de la podología y de la cirugía del pie y tobillo. El dolor del tercio medio del tendón es un problema habitual en corredores, pero también se ve en pacientes sedentarios. El término correcto para referirnos a esta lesión es el de tendinopatía aquílea no insercional. Existen numerosos tratamientos que intentan disminuir el dolor y mejorar la función del tejido lesionado. Los medios conservadores suelen tener buenos resultados, pero existe un porcentaje de pacientes que precisan cirugía. Presentamos una técnica poco invasiva para esta patología en la que utilizamos un dispositivo de radiofrecuencia para tratar la tendinosis. Palabras clave: tendón de aquiles; tendinosis; radiofrecuencia. AbStRACtAchilles tendon injuries are a common disease in podiatric and foot and ankle surgery consultation. Midportion pain is a frequent problem in runners but could be seen in sedentary people too. Correct term for this condition is non insertional Achilles tendinopathy. There are many treatment options that try to reduce the pain and improve the function of damaged tissue. Conservative treatments usually have good results but there are some cases that could need surgery. We present a minimally invasive technique using a radiofrequency microdebrider to treat the tendinosis. Key words: achilles tendon; tendinosis; radiofrequency.Sumario: 1. Introducción, 2. Concepto e indicaciones de la microtenotomía por radiofrecuencia (RF), 3. Aplicaciones, 4. Resultados, 5. Discusión, 6. Conclusiones, Bibliografía.Referencia normalizada: Sánchez Gómez, R., López Canapé, D., López López, D., Rodríguez Sanz, D., Soriano Medrano, A., Morales Ponce, A. Uso de la microtenotomía por radiofrecuencia con el dispositivo Topaz ® para el tratamiento de la tendinopatía aquílea no insercional. Rev. Int. Cienc. Podol. 2013; 7(1): 57-66.http://dx

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“…Electromyography and nerve conduction velocity studies are not consistent (DiMarcangelo & Yu, 1997;Komatsu, Takao, & Innami, 2011;Cheung & Zhang, 2006;Parrett, 2002;Tweed, Barnes, Allen, & Campbell, 2009). Baxter described operative decompression of the first branch of the lateral plantar nerve in 20patient with 34 heels; 82 percent of patients had complete relief Baxter & Thigpen, 1984).…”

Section: Diagotic and Treatment Optionsmentioning

confidence: 99%

“…The most common procedure is a partial plantar fasciotomy that may be either open or closed. Partial release of less than 40% of the fascia is recommended to minimize the effect on arch instability and maintain normal foot biomechanics (Cheung & Zhang, 2006). Total plantar fasciotomy, may lead to loss of stability of the medial longitudinal arch and abnormalities in gait, in particular an excessively pronated foot (Tweed, Barnes, Allen, & Campbell, 2009).…”

Section: Diagotic and Treatment Optionsmentioning

confidence: 99%

Evaluation of the Results of Endoscopic Release of Plantar Fascia in Cases of Resistant Chronic Heel Pain

Ahmed¹,

A²,

A³

et al. 2017

GJHS

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Aim: To evaluate the results of endoscopic release of plantar fascia in resistant cases of heel pain.Methods: An experimental descriptive study involved twenty patients who presented to University hospital with resistant chronic plantar heel pain due to plantar fasciitis, were treated with endoscopic plantar fasciotomy. All patients completed a period of at least six months follow up. Data were collected by the modified American Orthopaedic Foot and Ankle Society (AOFAS) Questionnaire, informed consent was applied, and SPSS was used for data entry and analysis.Results: At the end of follow up the mean modified AOFAS of ankle-hind foot score was improved from 49.10 (ranging from 34 to 56) pre-operatively to 90.25 post operatively (ranging from 67 to 100). Seven patients (35%) had excellent results, ten patients (50%) had good results, two patients had fair results, and one patient (5%) had a poor result. AOFAS score of pain was improved from a mean of 14.0+9.40 points pre-operatively (range 0 -20) to 31.5 + 6.71 points post-operatively (range 20 -40). AOFAS score of activity of daily living improved from a mean of 4+0 points pre-operatively to 9.85+0.671post-operatively ranging from 7 to 10 points. Conclusion:Endoscopic release of plantar fascia has positive therapeutic effects in cases of resistant chronic heel pain.Keywords: endoscopic, release, plantar fascia, resistant chronic heel pain Importance of StudyChronic plantar heel pain is one of the most common conditions affecting the foot, by an experimental descriptive study conducted to evaluate the results of endoscopic release of plantar fascia in resistant cases of heel pain, and concluded that endoscopic release of plantar fascia as a positive therapeutic method that is used in cases of resistant chronic heel pain.

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Consequences of Partial and Total Plantar Fascia Release: A Finite Element Study

Cited by 105 publications

References 21 publications

Deformation and stress distribution of the human foot after plantar ligaments release: A cadaveric study and finite element analysis

Deformation and stress distribution of the human foot after plantar ligaments release: A cadaveric study and finite element analysis

Uso de la microtenotomía por radiofrecuencia con el dispositivo Topaz® para el tratamiento de la tendinopatía aquílea no insercional

Evaluation of the Results of Endoscopic Release of Plantar Fascia in Cases of Resistant Chronic Heel Pain

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