Lateral Plantar Nerve Release with or without Calcaneal Drilling for Resistant Plantar Fasciitis

Abstract

Purpose. To compare the outcome following lateral plantar nerve release with or without calcaneal drilling for resistant plantar fasciitis. Methods. 30 women and 3 men aged 30 to 60 (mean, 45) years with resistant plantar fasciitis were randomised to undergo release of the first branch of the lateral plantar nerve with (group 1, n=18) or without (group 2, n=15) calcaneal drilling. Results. Patients were followed up for a mean of 27 months. According to the modified Mayo scoring system for plantar fasciotomy, group 1 was superior to group 2 in terms of score (93.9±6.97 vs. 83±8.2, p<0.001) and grading (15 excellent, 2 good, and one fair vs. 6 excellent, 4 good, and 5 fair; p=0.031). Three patients in group one and one patient in group 2 (16.7% vs. 6.6%, p=0.381) developed complications of heel numbness, foot oedema, and 2 cases of superficial wound infection, respectively. Conclusion. Adding calcaneal drilling to release of the first branch of the lateral plantar nerve achieves better outcome than release alone in patients with resistant plantar fasciitis.