Spontaneous distal rupture of the plantar fascia

Gitto, Salvatore; Draghi, Ferdinando

doi:10.1002/jcu.22531

Cited by 5 publications

(1 citation statement)

References 9 publications

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“…Furthermore, dynamic maneuvres facilitate confirmation of a complete tear by verifying the presence of a gap between the 2 torn parts of the PF. [14] Sonography is a repeatable (follow-up of the patient), costeffective and time-saving imaging modality that allows for dynamic evaluation and comparison with the contralateral side. Moreover, US imaging is superior to MRI in differentiating true fiber interruption from local edema, especially during the acute or sub-acute phase.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound follow-up of spontaneous tears of the plantar fascia treated with conservative therapies

Cocco¹,

Ricci

Boccatonda³

et al. 2019

Medicine

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Rationale: The plantar fascia (PF) is an important anatomical structure that stabilizes the longitudinal arch of the foot. While plantar fasciitis is a common pathology affecting the foot, tears of the PF are uncommon injuries characterized by acute pain in the plantar aspect of the foot. The main purpose of this paper was to describe, in detail, how the ultrasonographic pattern of PF rupture can be combined with the clinical features to define the prognosis and promptly plan the therapeutic approach.Patient concerns: In the first case, a 39-year-old male patient was seen due to acute pain in the mid plantar foot which appeared 3 days after a tennis match. The pain was accompanied by a "snap" noise and intense pain. In the second case, a 44-year-old male patient was seen due to pain in the heel region which appeared 2 days after a running session.Diagnosis: One case of noninsertional complete tear of the central bundle of the PF with retraction of the 2 stumps and 1 case of partial tear of the central bundle of the PF at the level of the insertional region.Interventions: Both patients were treated with conservative therapies including load management, oral nonsteroidal antiinflammatory drugs, foot orthosis, and restriction of sport activities.Outcomes: At follow-up, the patient with spontaneous complete tear of the PF (noninsertional area) showed a small fibrous bridge between the 2 stumps, with partial alignment of the proximal and distal portions, the ability to walk for a medium to long-distance, and difficulty going up and downstairs. The patient with the spontaneous partial tear (insertional area) showed complete fibrous scar tissue with restoration of the fascial continuity, and the ability to walk for a long-distance and go up and downstairs without pain.Lessons: Based on the clinical and ultrasonographic findings, we suggest that partial tear of the PF in the insertional region presents a favorable prognosis with complete recovery, both clinically and anatomically, while a complete tear in the noninsertional region is associated with partial functional and histological recovery when managed with a conservative approach. Therefore, coupling the clinical findings with the sonohistologic pattern is a valuable approach to plan the most suitable treatment for patients with spontaneous PF tear.Abbreviations: MRI = magnetic resonance imaging, PF = plantar fascia, US = ultrasound.

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Section: Discussionmentioning

confidence: 99%