Ultrasound-guided Plantar Fascia Release Technique

2009 ◽  
Vol 99 (3) ◽  
pp. 183-190 ◽  
Author(s):  
Praveen K. Vohra ◽  
Christopher J. Japour
Keyword(s):  
Rating Scale ◽  
Plantar Fascia ◽  
Skin Incision ◽  
Surrounding Tissue ◽  
Postoperative Infections ◽  
Ultrasound Guided ◽  
Heel Spur ◽  
Release Technique ◽  
The Mean ◽  
Plantar Fascia Release

Background: Ultrasound-guided plantar fascia release offers the surgeon clear visualization of anatomy at the surgical site. This technique uses small arthroscopic dissecting instruments through a 0.5-cm incision, allowing the surgeon to avoid the larger and more tissue-disruptive incision that is traditionally used for plantar heel spur resection and plantar fascia releases. Methods: Forty-one patients (46 feet) were selected for the study. The mean patient age was 47 years. Twenty-nine were considered obese with a body mass index greater than 30 kg/m2. Patients were functionally and subjectively evaluated 4 weeks after surgery using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Rating Scale. Results: Results from the study show a significant improvement (P = .05 confidence level) 4 weeks postoperatively for the 41 patients (46 feet), compared to their preoperative condition. The mean pretest score was 33.6 (range 10–52); this score improved to 88.0 (range 50–100), 4 weeks postoperatively. There were no postoperative infections or complications. Conclusions: The ultrasound-guided plantar fascia release technique is a practical surgical procedure for the relief of chronic plantar fascia pain because the surgeon is able to clearly visualize the plantar fascia by ultrasound. In addition, there is minimal disruption to surrounding tissue because small instruments are passed through a small 0.5-cm incision. The traditional open method of heel spur surgery, in contrast, uses a larger skin incision of 3 to 5 cm, followed by larger instruments to dissect to the plantar fascia. (J Am Podiatr Med Assoc 99(3): 183–190, 2009)

Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial

2021 ◽  
pp. 193864002098092
Author(s):  
Gholamreza Raissi ◽  
Amin Arbabi ◽  
Maryam Rafiei ◽  
Bijan Forogh ◽  
Arash Babaei-Ghazani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Corticosteroid Injection ◽  
Treatment Options ◽  
Plantar Fascia ◽  
Numeric Rating Scale ◽  
Therapeutic Effects ◽  
Ultrasound Guided ◽  
Double Blind

Design Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. Methods A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Conclusion Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Levels of Evidence: Level II

scholarly journals Ultrasound-Guided Plantar Fascia Release with Needle: A Novel Surgical Technique

2016 ◽  
Vol 06 (07) ◽  
pp. 159-170 ◽  
Author(s):  
A. Iborra ◽  
M. J. Villanueva ◽  
S. L. Barrett
Keyword(s):  
Surgical Technique ◽  
Plantar Fascia ◽  
Ultrasound Guided ◽  
Plantar Fascia Release

C0045 Ultrasound-guided ultraminimally invasive plantar fascia release

2018 ◽  
Author(s):  
Alvaro Iborra ◽  
Manuel Villanueva ◽  
Felipe Benito ◽  
Pablo Sanz ◽  
Guillermo Rodriguez Fabian
Keyword(s):  
Plantar Fascia ◽  
Ultrasound Guided ◽  
Plantar Fascia Release

scholarly journals A novel closed technique for ultrasound-guided plantar fascia release with a needle: review of 107 cases with a minimum follow-up of 24 months

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
A. Iborra ◽  
M. Villanueva ◽  
P. Sanz-Ruiz ◽  
Antonio Martin ◽  
Concepción Noriega
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Rehabilitation Program ◽  
Heel Pain ◽  
Ultrasound Guided ◽  
Lateral Column ◽  
Guided Surgery ◽  
Plantar Fasciotomy ◽  
Plantar Fascia Release

Abstract Background This study aims to analyze the clinical outcome of a new ultrasound-guided surgery for partial plantar fasciotomy performed with a needle for treatment of plantar fasciitis. Methods We performed a retrospective review of 107 patients diagnosed with plantar fasciitis who underwent ultrasound-guided release of the plantar fascia. The series included 62 males (57.9%) and 45 females (42.1%) treated between April 2014 and February 2018, with a mean follow-up of 21.05 ± 10.96 months (7–66) and a minimum follow-up of 24 months. The mean age was 48.10 ± 10.27 years (27–72). Clinical assessments and ultrasound examination were carried out before treatment, after 1 week, and then after 1, 3, 12, and 24 months. The clinical assessment was based on a visual analog scale and the Foot and Ankle Disability Index. Results Heel pain improved in 92.5% (99) of patients, but not in 7.4% (8 patients). In the group of patients whose heel pain improved, 9 experienced overload on the lateral column and dorsum of the foot, which improved with the use of plantar orthoses and a rehabilitation program. We recorded no nerve complications (e.g., paresthesia), vascular injuries, or wound-related problems. Conclusion Ultrasound-guided partial plantar fasciotomy with a needle is safe, since structures are under direct visualization of the surgeon and the risk of damage is minimal. Stitches are not necessary, and recovery is fast. Consequently, costs are low, and the patient can return to work quickly. This technique may represent a valid option for treatment of plantar fasciitis.

Development and Evaluation of a Simulation-based Curriculum for Ultrasound-guided Central Venous Catheterization

CJEM ◽  
2016 ◽  
Vol 18 (6) ◽  
pp. 405-413 ◽  
Author(s):  
Robert McGraw ◽  
Tim Chaplin ◽  
Conor McKaigney ◽  
Louise Rang ◽  
Melanie Jaeger ◽  
...  
Keyword(s):  
Rating Scale ◽  
Deliberate Practice ◽  
Venous Catheter ◽  
Global Rating Scale ◽  
Global Rating ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Simulation Based ◽  
Technical Proficiency ◽  
The Mean

AbstractObjectiveTo develop a simulation-based curriculum for residents to learn ultrasound-guided (USG) central venous catheter (CVC) insertion, and to study the volume and type of practice that leads to technical proficiency.MethodsTen post-graduate year two residents from the Departments of Emergency Medicine and Anesthesiology completed four training sessions of two hours each, at two week intervals, where they engaged in a structured program of deliberate practice of the fundamental skills of USG CVC insertion on a simulator. Progress during training was monitored using regular hand motion analysis (HMA) and performance benchmarks were determined by HMA of local experts. Blinded assessment of video recordings was done at the end of training to assess technical competence using a global rating scale.ResultsNone of the residents met any of the expert benchmarks at baseline. Over the course of training, the HMA metrics of the residents revealed steady and significant improvement in technical proficiency. By the end of the fourth session six of 10 residents had faster procedure times than the mean expert benchmark, and nine of 10 residents had more efficient left and right hand motions than the mean expert benchmarks. Nine residents achieved mean GRS scores rating them competent to perform independently.ConclusionWe successfully developed a simulation-based curriculum for residents learning the skills of USG CVC insertion. Our results suggest that engaging residents in three to four distributed sessions of deliberate practice of the fundamental skills of USG CVC insertion leads to steady and marked improvement in technical proficiency with individuals approaching or exceeding expert level benchmarks.

scholarly journals Outcomes of Endoscopic Treatment for Plantar Fasciitis: A Systematic Review

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0043
Author(s):  
Leona Ward ◽  
Yoshiharu Shimozono ◽  
John G Kennedy
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Endoscopic Procedure ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Postoperative Score ◽  
The Mean ◽  
Plantar Fascia Release

Category: Arthroscopy, Hindfoot Introduction/Purpose: Open plantar fascia release is an established surgical treatment for plantar fasciitis traditionally. However, it has long recovery period and complications with conflicting late results. Recently, endoscopic plantar fascia release has gained popularity, providing good outcomes with early return to activity. However, there is still a paucity of overall clinical data regarding outcomes and complication rates following endoscopic procedure for the treatment of plantar fasciitis. The purpose of the current study was to systematically review the outcomes of endoscopic plantar fascia release in the treatment of plantar fasciitis. Methods: A systematic review was preformed using, MEDLINE, EMBASE and Cochrane library databases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies included were evaluated with regards to level of evidence (LOE) and quality of evidence (QOE) using the Coleman methodological score. Clinical outcomes and complications were also evaluated. Results: Twenty-one studies including 601 feet were included in this systematic review. The mean patient age was 48.5±5.2 years, and the mean follow-up time was 26.9±22.7 months. Sixteen studies used the AOFAS score for clinical outcome measure. The mean preoperative AOFAS score was 52.3±24.1 and the postoperative score was 88.8±4.1. The VAS score was utilized in 10 studies. The mean preoperative score was 7.8±0.8 and the postoperative score was 1.8±0.7. In total 111 of 601 (18.7%) patients had complications. The most common complication was recurrence of pain with 45 patients (7.5%). Twenty-two patients (3.7%) experienced paraesthesia and numbnesss. Seventeen patients (2.8%) required subsequent operations including gastrocnemius release, hematoma drainage, and baxter nerve release. Conclusion: The current systematic review demonstrates that overall there were good clinical and functional outcomes following endoscopic procedure for the treatment of plantar fasciitis. However, there was a relatively high complication rate (18.7%) associated with the endoscopic procedures. Due to the low level of evidence and poor qualities of evidence, further well designed studies are necessary to determine the clinical outcomes and complications of endoscopic plantar fasciotomy.

Effect of the Interaction Between Hypertension and Cerebral White Matter Changes on the Progression of Alzheimer Disease

2018 ◽  
Vol 15 (14) ◽  
pp. 1354-1360 ◽  
Author(s):  
Ping-Song Chou ◽  
Yi-Hui Kao ◽  
Meng-Ni Wu ◽  
Mei-Chuan Chou ◽  
Chun-Hung Chen ◽  
...  
Keyword(s):  
White Matter ◽  
Alzheimer Disease ◽  
Rating Scale ◽  
Vital Role ◽  
Independent Effect ◽  
Cerebral White Matter ◽  
Clinical Dementia Rating ◽  
White Matter Changes ◽  
Age Related ◽  
The Mean

Background: Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate the AD progression through an independent or interaction effect is unknown. Objective: To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression. Method: A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral White Matter Changes (WMCs) in relation to hypertension. Annual comprehensive psychometrics were performed. WMCs were rated using a rating scale for Age-related WMCs (ARWMC). Results: In total, 278 patients with sporadic AD were enrolled in this study. The mean age of the patients was 76.6 ± 7.4 years, and 166 patients had hypertension. Among AD patients with hypertension, those with deterioration in clinical dementia rating-sum of box (CDR-SB) and CDR had significantly severe baseline ARWMC scales in total (CDR-SB: 5.8 vs. 3.6, adjusted P = 0.04; CDR: 6.4 vs. 4.4, adjusted P = 0.04) and frontal area (CDR-SB: 2.4 vs. 1.2, adjusted P = 0.01; CDR: 2.4 vs. 1.7, adjusted P < 0.01) compared with those with no deterioration in psychometrics after adjustment for confounders. By contrast, among AD patients without hypertension, no significant differences in ARWMC scales were observed between patients with and without deterioration. Conclusion: The effect of cerebrovascular pathologies on AD progression between those with and without hypertension might differ. An interaction but not independent effect of hypertension and WMCs on the progression of AD is possible.

scholarly journals AB0501 CORRELATION BETWEEN AXIAL AND PERIPHERAL ENTHESIS IN SPONDYLARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1278.1-1278
Author(s):  
H. Ferjani ◽  
M. Yasmine ◽  
K. Maatallah ◽  
E. Labbene ◽  
H. Riahi ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Chest Wall ◽  
Age Of Onset ◽  
Scoring Systems ◽  
Plantar Fascia ◽  
Anterior Chest Wall ◽  
Controlled Study ◽  
Asas Criteria ◽  
The Us ◽  
The Mean

Background:Enthesitis is the clinical hallmark of spondylarthritis. It refers to the inflammation of joint attach in the bone. Several sites enthesitis may be affected, and a wide variety of scoring systems were available.Objectives:We aimed to determine the prevalence of axial enthesitis in the anterior chest wall (ACW), and its correlation with peripheral sites especially, the Achilles tendon (AT).Methods:We conducted a prospective study including patients with SpA according to the ASAS criteria. Sociodemographic data, as well as disease characteristics, were recorded. The Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) was used to assess clinical entheses (first and seventh costochondral joints, posterior superior iliac spine, anterior superior iliac spine, iliac crest, and Achilles tendon insertion). The presence of enthesitis on the US was then assessed in the right and left sternoclavicular (SCJ), manubriosternal (MSJ) joints, as well as in the AT, using Esaote My Lab 50.Results:The study included 47 patients with SpA: axial (n=26), axial and peripheral (n=21). There was a female predominance (sex ratio: 0.2). The mean age was 42.2 years ± 12.6 [11-70]. The age of onset of the disease was <40 years in 59.6% of cases. Tenderness in entheseal sites was found in 63.8% of patients, especially in the plantar fascia and AT (32.7%, 6%, respectively). The mean MASES score was 2.9 [0-13]. Clinical ACW involvement (29.1%) was at follows: 1st right chondro-sternal joint (CSJ) (19.1%), 1st left CSJ (25.5%), 7th right CSJ (27.7%) and 7th left CSJ (31.9%).US involvement of the ACW was 14.3%. Enthesitis of the AT was found in 70% of cases on US examination. ACW US involvement was correlated neither to the BMI nor to MASES score (p=0.16, p=0.6 respectively). Similarly, there was no correlation between the presence of US ACW enthesitis and clinical nor the US AT enthesitis (p=0.09, p=0.209, respectively).Conclusion:Our study showed that ACW enthesitis is frequent in SpA, especially by US screening. This axial enthesitis, don’t necessarily reflect a simultaneous clinical or US involvement of the peripheral entheses. Further studies are needed to characterize this subtype of SpA.References:[1]Verhoeven F, Guillot X, Godfrin-Valnet M, Prati C, Wendling D. Ultrasonographic evaluation of the anterior chest wall in spondyloarthritis: a prospective and controlled study. J Rheumatol. 2015;42(1):87-92Disclosure of Interests:None declared.

scholarly journals Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Deng ◽  
Xiao-min Hou ◽  
Xu-yan Zhou ◽  
Qing-he Zhou
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Prospective Randomized Controlled Trial ◽  
Numerical Rating ◽  
Intercostal Block ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery. Methods Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups. Results The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons). Conclusion Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.

Modified endoscopic ultrasound-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS): a pilot study

Endoscopy ◽  
2021 ◽  
Author(s):  
Amanda Marino ◽  
Ali Bessissow ◽  
Corey Miller ◽  
David Valenti ◽  
Louis Boucher ◽  
...  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Outlet Obstruction ◽  
Stent Migration ◽  
Stent Insertion ◽  
Ultrasound Guided ◽  
Double Balloon ◽  
Low Residue Diet ◽  
The Mean

Abstract Introduction We recently developed a double-balloon device, using widely available existing technology, to facilitate endoscopic ultrasound-guided gastroenterostomy (EUS-GE). Our aim is to assess the feasibility of this modified approach to EUS-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS). Methods This was a single-center retrospective study of consecutive patients undergoing M-EPASS from January 2019 to August 2020. The double-balloon device consists of two vascular balloons that optimize the distension of a targeted small-bowel segment for EUS-guided stent insertion. The primary end point was the rate of technical success. Results 11 patients (45 % women; mean [standard deviation (SD)] age 64.9 [8.6]) with malignant gastric outlet obstruction were included. Technical and clinical success (ability to tolerate an oral diet) were achieved in 91 % (10/11) and 80 % (8/10) of patients, respectively. There was one adverse event (9 %) due to stent migration. Two patients (18 %) required re-intervention for stent obstruction secondary to food impaction. The mean (SD) time to a low residue diet was 3.5 (2.4) days. Conclusion M-EPASS appears to facilitate the technique of EUS-GE, potentially enhancing its safety and clinical adoption. Larger studies are needed to validate this innovative approach to gastric outlet obstruction.

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