Percutaneous medial band plantar fasciotomy for treatment of chronic plantar hallux ulcers

Abstract

Diabetic foot ulcers have a high recurrence rate after healing.¹ The most common ulcer location is in the hallux.² Infection of the hallux requiring first ray amputation have a high incidence of progression to a transmetatarsal or transtibial amputation. There are a variety of surgical procedures performed to treat and prevent neuropathic foot ulcers based on anatomic location of the ulcer. Options to treat the plantar hallux ulceration include arthroplasties and tendon releases, which carry the risk of infection and transfer ulcer.⁴⁻⁸ Recently, a selective plantar fascia release was described to offload diabetic forefoot ulcers.⁹ We demonstrate a percutaneous modification using an 18-gauge needle to release the medial plantar fascial band to treat plantar hallux ulcers with potentially less complications than arthroplasties.

Keywords

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