Mechanical behavior of the foot and ankle after plantar fascia release in the unstable foot

Harold B. Kitaoka, Zong Ping Luo, Kai Nan An

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

The change in position of the bones of the foot was studied in three dimensions after plantar fascia release in intact and destabilized feet. Fifteen fresh-frozen human foot specimens were used. Physiologic loads of 445 newtons were applied axially to simulate standing at ease, and the three- dimensional position of tarsal bones was determined with a magnetic tracking device. The positions were presented in the form of screw axis displacements, quantitating rotation, and axis of rotation orientation. After fasciotomy in the six intact feet, significant differences in rotation were observed at the talotibial and calcaneotalar levels. After fasciotomy in the four unstable feet with three supporting elements sectioned, significant differences in position were observed at the talotibial joint and a significant decrease in arch height was observed. After fasciotomy in the five unstable feet with five supporting elements sectioned, significant differences in rotation were observed at the talotibial joint (mean, 5.5 ± 1.6°; P = 0.001), calcaneotalar joint (mean, 6.1 ± 2.1°; P = 0.003), and metatarsotalar level (mean, 9.3 ± 4.1°; P = 0.007). The average decrease in arch height was 7.4 ± 4.1 mm (P = 0.015). Displacement of all joints tested occurred after fasciotomy, with rotation about all three axes. These changes in displacement were more pronounced in unstable or destabilized feet. The data suggest that operations involving fasciotomy affect arch stability and should not be performed in patients with evidence of concomitant pes planus deformity, because of the likelihood of further deformation.

Original languageEnglish (US)
Pages (from-to)8-15
Number of pages8
JournalFoot and Ankle International
Volume18
Issue number1
DOIs
StatePublished - Jan 1997

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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