A retrospective study of 195 patients with heel pain.
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Biomedical subjects
Publications and source records attributed to M A Figura.
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Fractures of the metatarsals are a common condition seen by all health care specialists. They may be precipitated by direct or indirect trauma to the specific area of concern. This article is a review of the angiology of the metatarsal. It provides a workable classification of metatarsal fractures and provides an insight into their proper treatment.
Peroneus tertius myocele has not been reported in the literature. A case report and long term follow-up is presented.
Macrodactyly, the exact etiology of which is unknown, is a rare congenital deformity. Four basic surgical approaches to correction have been considered. When the first and second digits are involved, Dr. Figura believes that amputation should not be considered as these two digits are necessary for stability. He believes the worm advancement of Tsuge, which can be performed on any toe, to be the procedure of choice, both functionally and cosmetically. The metatarsophalangeal joint is not disturbed, the digit is not syndactylized into a bulbous mass, the nail is left intact, and the functions are preserved.
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The results of a 5-year follow-up of patients who underwent surgical partial release of plantar fascia with plantar skin incision for treatment of chronic heel pain are presented. Evaluation included survey results from both a modified Mayo Scoring System and a list of specific questions developed by the authors. Thirty-three feet of 30 patients are evaluated. Thirty of the 33 feet studied achieved good or excellent results, scoring 80 or better on a 100-point scale. Ninety percent pain relief was achieved in 27 of the 33 feet studied (81.8%). A satisfaction rate of 90% or better was found with 30 of the 33 feet studied (90.9%). Long-lasting complications were described by five patients, including opposite foot pain, dorsal foot pain after extended activity, scar tissue discomfort, callus at scar area, and continued heel pain.
A review of the anatomy, etiology, and conservative and surgical treatments of plantar fasciitis are presented and a simple surgical technique is introduced. The medial instep plantar fasciotomy was performed by the authors on 50 feet previously untreated by surgery (41 patients). The follow-up results (average length of time to follow-up was 11.3 months) revealed that 82.6% of the patients experienced at least 90% pain relief and 97.8% experienced at least 80% pain relief. Overall, 91.3% of the patients related at least 80% satisfaction with the results of the surgery and all but one of the patients stated that they would recommend and/or have the procedure performed again if the need arose. Complications arising from the instep procedure were limited, and the most frequent complaint was scar formation. Stress was placed on exhausting conservative measures before attempting surgical correction, and the average patient utilized five different modalities of conservative treatment over an average period of 13 months. Postoperatively, patients were encouraged to continue, or begin using, orthotics/arch supports to avoid problems such as arch pain.