Clinical outcome of surgical intervention for recalcitrant infero-medial heel pain.

A retrospective review was conducted in 28 patients (31 feet) with recalcitrant infero-medial heel pain, to assess the clinical outcome of a combined release of the first branch of the lateral plantar nerve and the plantar fascia. All patients were questioned by telephone interview on their pre- versus post-operative level of pain and function (based on the Kitaoka mid-foot scale and the visual analog scale), and their satisfaction with the result of the intervention. Limitations of functional activity decreased, maximum walking distance increased and the level of pain decreased from 8.9 to 1.4 on the visual analog scale. The majority of patients was satisfied with the surgery (90.3%) and would undergo the same procedure again or would recommend it (92.9%). While conservative management remains the gold standard for treatment of infero-medial heel pain and/or plantar fasciitis, patients with recalcitrant disease usually can be effectively treated surgically with a combined release of the plantar fascia and the first branch of the lateral plantar nerve.