• Ahmed Shawkat Rizk, Wael A Kandel, Eslam Abd Elshafi Tabl, and Mahmoud I Kandil.
• 1 Benha Faculty of Medicine, Benha University, Benha, Egypt.
• Foot Ankle Int. 2017 Nov 1; 38 (11): 1271-1277.

BackgroundHeel pain with or without calcaneal spur is a challenging problem. Once conservative measures have failed, surgery may be indicated; there has been debate about the best surgical procedure. Two standard operative procedures have been either releasing the plantar fascia or removing the spur with drilling of the calcaneus. In this study, we evaluated the results of percutaneous drilling of the calcaneus combined with mid-sole release of the plantar fascia for treatment of resistant heel pain.MethodsThis study included 20 cases with resistant heel pain after failure of conservative measures for 6 months. Clinical, radiological evaluation and scoring patients' conditions according to the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scale was done preoperatively and postoperatively. Percutaneous drilling of the calcaneus combined with mid-sole release of the plantar fascia was done in all cases, and the functional results were evaluated through the follow-up period that extended from 9 to 16 months with a mean duration of 12 ± 2.3 months.ResultsThere was statistically significant improvement in the mean AOFAS Ankle-Hindfoot scale score from 50.8 ± 7.5 preoperatively to 91.6 ± 7 postoperatively at the last follow-up. There were no surgery-related complications, and the mean time for full recovery was 8 ± 3.7 weeks with no recurrence of pain by the last follow-up.ConclusionsThe results were very satisfactory with using this minimally invasive and simple technique for treatment for resistant heel pain.Level Of EvidenceLevel IV, retrospective case series.

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