| Plantar fasciitis is the tearing, inflammation and | | | | Society Ankle and Hindfoot Rating Scale and |
| subsequent degeneration of the plantar fascia, a | | | | significant improvements were noted compared |
| long ligament in the bottom of the foot. Plantar | | | | to baseline (before surgery). There were no |
| fasciitis develops due to overuse, poor shoes and | | | | complications during the study period. The authors |
| or abnormal foot mechanics. Common | | | | concluded that ultrasound-guided endoscopic |
| conservative treatments for plantar fasciitis | | | | release is a safe and effective surgical procedure |
| include eliminating the aggravating factors, icing the | | | | for the treatment of chronic plantar fasciitis. |
| heel, contrasting between hot and cold, stretching, | | | | Ultrasound can be used to visualize and evaluate |
| supportive shoes, orthotics or semi-rigid arch | | | | the thickness of the plantar fascia. Fascia |
| supports, night splints, taping and steroid injections. | | | | thickness has been shown to correlate with heel |
| Ninety percent of patients will respond to | | | | pain. An ultrasound records the echo of sound |
| conservative treatments. Extracorporeal shock | | | | waves reflected off an object, such as a |
| wave therapy or surgery are options for more | | | | ligament, tendon or bone. More dense objects, |
| chronic cases, which are not responsive to | | | | such as bone, will appear brighter. Less dense |
| conservative therapy. Surgical options include | | | | objects, such as air or inflammation, will appear |
| coblation therapy (radio frequency technique still | | | | darker or black on the ultrasound image. |
| being studied), endoscopic plantar fascial release | | | | A thickened and inflamed fascia, which occurs in |
| (EPF) and open heel surgery. In some cases open | | | | plantar fasciitis, will appear black on ultrasound. |
| heel surgery may be beneficial, but there is less | | | | The advantage of using endoscopy for the |
| trauma to the surrounding tissues and a faster | | | | surgical release is minimal trauma to the |
| healing time with the endoscopic technique. | | | | surrounding tissues which translates to a faster |
| Ultrasound-guided endoscopic plantar fascia | | | | healing time. Combining the use of ultrasound |
| surgery is a new variation of the traditional EPF | | | | imaging with the endoscopic fascial release allows |
| technique. A recent study (J Am Podiatry Med | | | | for better visualization and more precise |
| Assoc 99(3): 183-190, 2009) evaluated the safety | | | | anatomical dissection of the plantar fascia. Further |
| and effectiveness of ultrasound-guided plantar | | | | studies are needed to compare ultrasound guided |
| fascia release for treatment of chronic plantar | | | | plantar fascial release to the traditional endoscopic |
| fasciitis. | | | | plantar fascial release. This study had only a short |
| Forty-one patients had ultrasound-guided | | | | term follow-up and studies with long term |
| endoscopic plantar fascial release on forty six | | | | follow-up will be helpful in further determining the |
| feet. They were evaluated after four weeks | | | | safety and effectiveness of this procedure. |
| using the American Orthopedic Foot and Ankle | | | | |