Functional outcome of mid-sole percutaneous plantar fasciotomy versus open plantar fasciotomy in treatment of refractory plantar fasciitis

Background Plantar fasciitis is one of the main causes of heel pain, which is one of the most prevalent complaints in foot and ankle clinics. Surgery may be necessary if conservative therapies have failed. The appropriate surgical technique has been debated, open plantar fasciotomy and percutaneous plantar fasciotomy are the two common surgical techniques. The aim of the study is to compare the outcomes of open release versus percutaneous midsole release of the plantar fascia in this study to treat recalcitrant heel pain. Methods A prospective study was conducted on 54 patients who had unresponsive plantar fasciitis following conservative treatment for at least six months. 20 patients in the 54 enrolled cases had open plantar fascia release, whereas the remaining 34 patients had percutaneous mid-sole plantar fascia release. All patients' surgical outcomes were evaluated using the Foot and Ankle Disability Index (FADI) both before and after the procedure and a follow-up period of one year was used to assess the functional results. Results The percutaneous plantar fasciotomy group's mean foot and ankle disability index score improved statistically significantly from 39 ± 6 preoperatively to 101 ± 3 postoperatively, compared to 38 ± 5 preopera tively and 98 ± 2 postoperatively for the open plantar fasciotomy group at the final follow-up. Two patients in the percutaneous group experienced numbness at the site of surgery, compared to seven in the open group. By the time of the last follow-up, there had been no recurrence of pain. Discussion We performed a percutaneous release of the mid-sole plantar fascia with a minimum incision and little dissection. We could thus access the plantar fascia effectively while preserving the surrounding tissues and maintaining optimal cosmetic results. Open plantar fascia release is the most conventional technique. However, disadvantages of the surgery include large wound, longer postoperative recovery time, and potential postoperative occurrence of complex regional pain syndrome. Conclusion Both open and percutaneous plantar fascia releases resulted in a considerable improvement in the patients' limb function and pain symptoms. The long-term curative results of the two surgical treatments were identical. Due to fewer postoperative problems, percutaneous plantar fascia release is a superior procedure.