Abstract

MOTA, Pedro et al. Libertação do Gastrocnémio Proximal Medial no Tratamento da Fasceíte Plantar Crónica: Uma Série de Casos. Rev. Port. Ortop. Traum. [online]. 2018, vol.26, n.2, pp.98-105. ISSN 1646-2122.

Purpose The purpose of this study is to present the results of surgical treatment of chronic plantar fasciitis (CPF) with a recent technique. Material and Methods We performed a retrospective study. Ten patients diagnosed with CPF, refractory to conservative treatment, were submitted to proximal medial gastrocnemius release (PMGR), nine after conservative treatment failure and one after conservative treatment and plantar fasciotomy failure. Six patients were submitted to surgery bilaterally and the other four, unilaterally. AOFAS score was recorded before and after surgery. Results Follow-up is superior to one year for every patient. All the patients refer symptomatic improvement after surgery and those submitted to one-side surgery, when asked if they would accept surgery to the contralateral side if the problem appeared, gave a positive response. AOFAS score was, on average, 76 before surgery and 97 (86-100) after surgery, with 12 out of 16 cases with maximum score (100). We did not observe any complication. Conclusion The rationale for this surgical procedure is a tight gastrocnemius, which can be assessed clinically with the Silfverskiold test. In this series, every patient had a positive Silfverskiold test which can explain why the procedure was successful. It remains unclear is this procedure is efficient in patients without gastrocnemius tightness. Analyzing our results, in conjunction with the literature, we consider PMGR a secure and efficient treatment for CPF, in patients with gastrocnemius contracture.

Keywords : Plantar fasciitis; gastrocnemius contracture; Silfverskiold test; proximal medial gastrocnemius release.

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