A prospective study of surgical excision of calcaneal spur for relief of chronic heel pain.

Abstract

Introduction :Plantar calcaneal spur is characterized as the bony outgrowth of calcaneal tuberosity and may occur in approximately 15% of the general population and in a higher proportion among the elderly, obese, heel pain and plantar fasciitis patients and irregular foot biomechanics. The objective of this study is to determine the subjective and functional outcome of calcaneal spur excision with regard to chronic heel pain after failure of conservative treatment and plantar fascia release surgery and to assess potential complications after surgery.Methods : After obtaining informed consent, 30 patients attending the inpatient and outpatient facilities of the orthopaedics department of the tertiary care center Kolar, India with diagnosis of calcaneal spur as the clinical suspect and confirmation with radiology, were taken for the study. There were regular blood investigations. The seriousness of the disorder was measured by Visual Analog Scale for the pain and subjective rating by Roles Maudsley Score. The functional outcome of the operation was measured before and after surgery by the Ankle and Hind Foot Scale.Results: The study population of 30 patients was primarily female (60 percent). The period of symptoms in all patients with failed conservative management and plantar fascia release surgery was more than six months. Thirty patients were subjected to a plantar spur excision approach. All thirty patients had a six- month follow up period. The pain score of the preoperative Visual Analog Scale was 7.07+/-0.82 and the mean Visual Analog Scale score was 3.60+/-0.56 at six months follow up. The mean preoperative Ankle and Hind Foot scale was 56.73+/-3.92 and 83.40+/-4.59 respectively at six months. Roles Maudsley Score with a good result (significant improvement before treatment).Conclusion:Spur excision can be successful in chronic heel pain relief in patients with ineffective conservative management and failed plantar fascia release surgery.A secure operation with minimal complications is heel spur surgery. To further validate the research, a majority of studies in larger groups of populations are required.