The relationship between age-related incidences of heel spur with sex and side / Relación entre la incidencia del espolón calcáneo con la edad, sexo y lado

SUMMARY: Heel spur is an osteophytic protrusion larger than 2 mm that lies just anterior to the tuberosity of the calcaneus. Heel spur can be of two types: plantar heel spur and dorsal heel spur. The aim of this study was to evaluate the relationship between the heel spurs incidence with age, sex and side. A total of 2000 bilateral radiographs of 1000 patients (518 men and 482 women) aged 20-93 years who applied to Terme state hospital, Samsun, Turkey due to trauma were examined. Patients were grouped into 10 year age ranges (20-29 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years and over 70 years). The incidences of plantar heel spur, dorsal heel spur, and both were evaluated according to age, sex and side relations. Plantar or dorsal heel spurs were detected in 32.6 % (326 patients) of the patients. The incidences of plantar heel spur, dorsal heel spur, plantar and dorsal heel spur were 26.0 %, 16.9 %, and 10.3 % respectively. According to sex, the incidence of plantar heel spur was higher in women in all age groups. Although the incidence of dorsal heel spur was higher in men in the 6th decade, it was more common in women in other age groups. The incidence of plantar heel spur was 2.615 times higher in the right foot and 2.810 times higher in the left foot in women. As the age increased, the risk of plantar heel spur increased 1.060 times in the right foot and 1.061 times in the left foot. The incidence of dorsal heel spur was 1.510 times higher in the right foot and 1.715 times higher in the left foot in women. As the age increased, the incidence of dorsal heel spur increased in both feet and this increase was 1.055 times in both feet.

RESUMEN: El espolón calcáneo es una protuberancia osteofítica de más de 2 mm que se encuentra por delante de la tuberosidad del calcáneo. El espolón calcáneo puede ser de dos tipos: espolón calcáneo plantar y espolón calcáneo dorsal. El objetivo de este estudio fue evaluar la relación entre la incidencia de espolón calcáneo con la edad, el sexo y el lado. Se examinaron un total de 2000 radiografías bilaterales de 1000 pacientes (518 hombres y 482 mujeres) de 20 a 93 años de edad que fueron solicitadas en el hospital estatal de Terme, Samsun, Turquía debido a un traumatismo. Los pacientes se agruparon en rangos de edad de 10 años (20-29 años; 30-39 años; 40-49 años; 50-59 años; 60-69 años y mayores de 70 años). Las incidencias de espolón calcáneo plantar, espolón calcáneo dorsal y ambos se evaluaron de acuerdo con la edad, el sexo y lados. Se detectaron espolones calcáneos plantares o dorsales en el 32,6 % (326 pacientes) de los pacientes. Las incidencias de espolón calcáneo plantar, espolón calcáneo dorsal, espolón calcáneo plantar y dorsal fueron del 26 %, 16,9 % y 10,3 %, respectivamente. Según el sexo, la incidencia de espolón calcáneo plantar fue mayor en mujeres en todos los grupos de edad. Aunque la incidencia del espolón calcáneo dorsal fue mayor en hombres en la sexta década, era más común en mujeres en otros grupos de edad. La incidencia de espolón calcáneo plantar fue 2,6 veces mayor en el pie derecho y 2,8 veces mayor en el pie izquierdo en mujeres. A medida que aumentaba la edad, el riesgo de espolón calcáneo plantar aumentaba 1,06 veces en el pie derecho y 1,061 veces en el pie izquierdo. La incidencia de espolón calcáneo dorsal fue 1,510 veces mayor en el pie derecho y 1,715 veces mayor en el pie izquierdo en mujeres. A medida que aumentaba la edad, la incidencia de espolón calcáneo dorsal aumentaba en ambos pies y este aumento era de 1,055 veces en ambos pies.

Morphometric analysis of calcaneal (heel) spurs in ancient and modern Anatolian populations / Análisis morfométrico de los espolones calcáneos en poblaciones de Anatolia antiguas y modernas

SUMMARY: Heel spurs are the bony protrusion seen especially on the dorsal and plantar face of the calcaneus bone at the attachment site of the muscles. It was aimed herein to obtain data about the life styles, daily lives, and especially the socioeconomic structures of modern and ancient Anatolian populations by evaluating the prevalence, location, age, and gender differences of heel spurs on the calcaneus and comparing these findings between the populations. Herein, the 251 calcaneus bones of 137 skeletons, which had been previously analyzed paleodemographically and dated to the Middle Ages, and 68 calcaneus bones belonging to a modern population, whose gender was unknown but lived in Anatolia, were examined in terms of heel spurs. In the current study, the presence of dorsal, plantar, or both dorsal/plantar heel spurs on these in 251 calcaneus bones was 43.9 %, 11.1 %, and 10.3 %, respectively. The presence of dorsal, plantar, or both dorsal/plantar heel spurs was determined as 22 %, 3 %, and 1.5 %, respectively, among the 68 calcaneus bones belonging to the modern population. When a comparison was made of the current study with studies in the literature on modern and prehistoric populations, a higher prevalence of heel spurs was found in prehistoric samples than in modern populations. It is our belief that this situation may have derived from the heavy labor force, environmental, or sociocultural differences in ancient Anatolian populations, insufficiency of vital materials due to inadequate industrial conditions, and the solution of anatomical disruption. In addition, the findings determined herein will guide the development of future and industrial studies on the foot and foot structure.

RESUMEN: Los espolones del talón son la protuberancia ósea que se ve especialmente en la cara dorsal y plantar del hueso calcáneo en el sitio de inserción de los músculos. El objetivo de este trabajo consistió en obtener datos sobre los estilos de vida, la vida cotidiana y, especialmente, las características socioeconómicas de las poblaciones anatolias modernas y antiguas mediante la evaluación de la prevalencia, la ubicación, la edad y las diferencias de sexo de los espolones calcáneos y comparar estos hallazgos entre los poblaciones. La muestra consistió en 251 calcáneos correspondientes a 137 esqueletos, que habían sido previamente analizados paleodemográficamente y fechados en la Edad Media; también se incluyeron 68 calcáneos pertenecientes a una población moderna de Anatolia, sin distinción de sexo. De la muestra de 251 calcáneos, se encontraron espolones calcáneos dorsales, plantares y dorsales/plantares, en el 43,9%, 11,1 % y 10,3 %, respectivamente. La presencia de espolones calcáneos dorsales, plantares y dorsales/plantares se determinó en el 22%, 3% y 1,5%, respectivamente, entre los 68 calcáneos pertenecientes a la población moderna. Cuando se realizó una comparación del estudio actual con la literatu- ra sobre poblaciones modernas y prehistóricas, se encontró una mayor prevalencia de espolones calcáneos en muestras prehistóricas que en poblaciones modernas. Creemos que esta situación puede haberse derivado a la gran fuerza de trabajo, y las diferencias ambientales o socioculturales en las antiguas poblaciones de Anatolia, la insuficiencia de materiales vitales debido a las condiciones industriales inadecuadas produjo la alteración anatómica. Además, los hallazgos aquí determinados guiarán el desarrollo de estudios futuros e industriales sobre la estructura del pie.

Dolor plantar calcáneo. Experiencias y opciones de tratamiento / Calcaneal plantar pain. Experiences and treatment options

La talalgia se define como la percepción de dolor localizado en el talón que anatómicamente corresponde al hueso calcáneo y a las partes blandas colaterales, constituye la causa más frecuente de consulta a los especialistas en pie y tobillo, identificando dos zonas de aparición del dolor, el dolor plantar y el dolor posterior, los que están directamente relacionados con la inervación de esa zona del pie, realizamos un análisis general para evaluar las opciones iniciales de tratamiento y las indicaciones fisioterapéuticas exponiendo nuestra opinión y experiencias(AU)

Talalgia is defined as the perception of localized pain in the heel that anatomically corresponds to the calcaneus bone and collateral soft tissue, is the most frequent cause of consultation with foot and ankle specialists, identifying two areas of pain appearance, pain plantar and subsequent pain, which are directly related to the innervation of that area of the foot, we perform a general analysis to evaluate the initial treatment options and physiotherapeutic indications exposing our opinion and experiences(AU)

Relationship of the Shape of Subacromial Spur and Rotator Cuff Partial Thickness Tear

BACKGROUND: The present study was undertaken to evaluate the relationship between location of the rotator cuff tear and shape of the subacromial spur. METHODS: Totally, 80 consecutive patients who underwent arthroscopic repair for partial thickness rotator cuff tear were enrolled for the study. Bigliani's type of the acromion, type of subacromial spur, and location of partial thickness tear of the rotator cuff were evaluated using plain X-ray and magnetic resonance imaging. We then compared the groups of no spur with spur, and heel with traction spur. RESULTS: Of the 80 cases, 25 cases comprised the no spur group, and 55 cases comprised the spur group. There was a significant difference in type of tear (p=0.0004) between these two groups. Bursal side tears were significantly greater (odds ratio=6.000, p=0.0007) in the spur group. Subjects belonging to the spur group were further divided into heel (38 cases) and traction spur (17 cases). Comparing these two groups revealed significant differences only in the type of tear (p=0.0001). Furthermore, the heel spur had significantly greater bursal side tear (odds ratio=29.521, p=0.0005) as compared to traction spur. CONCLUSIONS: The heel spur is more associated to bursal side tear than the traction spur, whereas the traction spur associates greater to the articular side tear.

Arthroscopic heel spur fasciotomy for treatment of elderly refractory plantar fasciiti / 第二军医大学学报

Objective To evaluate the efficacy of arthroscopic heel spur fasciotomy for the treatment of refractory plantar fasciitis in elderly patients. Methods Twenty-two patients with plantar fasciitis diagnosed from Jan. 2014 to Jun. 2017 in the Department of Orthopedics of Changzheng Hospital of Navy Medical University (Second Military Medical University) were enrolled. All the patients aged≥70 years old, with the course lasting for more than 6 months and incurable pain after a variety of treatment, and received arthroscopic heel spur removal and partial iliac fascia lysis. The time for the recovery of daily walking was recorded. The visual analogue scale (VAS) score and the calcaneodynia score (CS) at 1 month after surgery and the 12-item short-form health survey questionnaire (SF-12) score at 6 months after surgery of the patients were analyzed and compared with the preoperative data to evaluate the curative effect. Results The average time for recovery of daily walking in the 22 patients was (12.4±5.5) d. Two patients with bilateral plantar fasciitis were lost to followup after surgery, and a total of 20 patients (22 feet) were followed up. Compared with pre-operation, the VAS score and CS of patients were significantly improved at 1 months after surgery (0.7 [0.0-3.2] vs 5.3 [3.8-7.0], Z＝2.1, P<0.01; 87.0±11.3 vs 38.9±10.1, t＝14.2, P<0.01). The physiological and psychological scores of SF-12 of patients were significantly increased at 6 months after operation versus pre-operation (50.9±10.7 vs 45.3±9.6, 47.2±9.2 vs 34.2±10.6; t＝4.3 and 4.1, both P<0.01). Conclusion Arthroscopic heel spur removal with partial iliac fascia lysis can effectively relieve the symptoms of patients with plantar fasciitis, without serious complications.

Efectividad de la terapia Su-Jok en pacientes con dolor por espolón calcáneo / Effectiveness of the Su-Jok therapy in patients with pain due to heel spur

Se realizó una intervención terapéutica en 128 pacientes con dolor por espolón calcáneo, seleccionados aleatoriamente, quienes fueron tratados en el Departamento de Rehabilitación del Hospital General Docente "Orlando Pantoja Tamayo" en el municipio de Contramaestre, de la provincia de Santiago de Cuba, de enero del 2014 a abril del 2015, con vistas a evaluar la efectividad de la terapia Su-Jok. Se conformaron 2 grupos: uno de control, que recibió tratamiento convencional, y otro de estudio, en el cual se aplicó la terapia Su-Jok. Luego de efectuado el análisis estadístico mediante las pruebas de hipótesis de homogeneidad de la Χ² y de diferencias de medias (ambas técnicas con un error permisible de 5 %), pudo concluirse que la terapia Su Jok es efectiva para aliviar el dolor por espolón calcáneo, por lo que se recomendó promoverla para ello debido a su fácil empleo y bajo costo.

A therapeutic intervention was carried out in 128 randomly selected patients with pain due to heel spur, who were treated in the Rehabilitation Department of "Orlando Pantoja Tamayo" Teaching General Hospital in Contramaestre municipality, Santiago de Cuba province, from January, 2014 to April, 2015, with the aim of evaluating the effectiveness of the Su-Jok therapy. Two groups were formed: a control group which received conventional treatment, and a study group, in which the Su-Jok therapy was applied. After the statistical analysis was carried out by means of the homogeneity and hypothesis tests of homogeneity of Χ2 and the means differences (both techniques with a permissible error of 5%), it could be concluded that the Su-Jok therapy is effective to mitigate the pain due to heel spur, so it was recommended to promote it taking into account its easy use and low cost.

Clinical features and correlation between radiographic parameters and incidence of calcaneal spur / 中华创伤骨科杂志

Objective To analyze the clinical features and the correlation between radiographic parameters and incidence of calcaneal spur in the patients from Nanfang Hospital,Southern Medical University,China.Methods Three experienced observers independently used the image acquisition and transmission system (PACS) to collect the data of lateral and axial X-ray images of calcaneus or ankle joint in neutral position from the patients with calcaneal spur and normal controls who had undergone radiological examination in Nanfang Hospital,Southern Medical University from July 2014 through December 2015.Ten radiological parameters of the foot (B(o)hler angle,Gissane angle,calcaneal inclination angle,talocalcaneal angle,talus horizontal angle,posterior facet inclination angle,calcaneal length,height of the posterior facet,absolute foot height,and calcaneal width) were measured in both the patients and normal controls.The location,morphology and length of calcaneal spurs were compared between genders,sides and age groups.Results A total of 216 parpatients were included in the study.Female patients were more than male ones,simple plantar spurs more than simple achilles tendon ones,type B spurs more than type A ones,the length of achilles tendon spurs larger than that of plantar ones,female plantar spurs more than males ones,and the length of right foot plantar spurs larger than that of left foot ones.All the differences above were statistically significant (P ＜ 0.05).There were no significant differences in the location,morphology or length of calcaneal spurs between the age group of ≤ 60 years old and the age group of ＞ 60 years old (P ＞ 0.05).The incidence of calcaneal spur were significantly correlated to Gissane angle (P =0.000,OR =0.944,95％ CI 0.917-0.973),posterior facet inclination angle (P=0.017,OR=0.957,95％ CI 0.924-0.992) and height of the posterior facet (P =0.007,OR =0.933,95％ CI O.886-0.981).Conclusions Calcaneal spur favored more females than males.Plantar spurs were more common than Achilles ones.Plantar spurs of Type B were more common than those of Type A.Achilles spurs were longer than plantar ones.More females suffered plantar spur than males.Right foot spurs were longer than left foot ones.Age had no significant influence on the spur characteristics.The incidence of spur might have been related to the Gissane angle,posterior facet inclination angle and height of the posterior facet of the foot.

Extracorporeal shock wave therapy for treatment of heel pain / 中华全科医师杂志

To explore the therapeutic efficacy of extracorporeal shock wave (ESW) for persistent heel pain.A total of 98 patients of persistent heel pain were randomly divided into ESW treatment and control groups (n =49 each).Treatment group had ESW while control group received infrared physical therapy.And their visual analogue scale (VAS) scores were assessed.After one course of treatment, VAS heel pain and function scores were (39.6 ± 6.2) and (25.1 ± 4.6) in ESW group versus (32.3 ± 6.5) and (17.4 ±7.2) in control group.And before treatment, (16.5 ±4.6) and (14.4 ±8.6), (16.1 ±4.7) and (14.6 ± 8.4) respectively.Heel pain significantly decreased with functional improvement (all P ＜ 0.05).After one course, the effective rate was 65％ (32/49) in treatment group.And the improvement rate of 31％ (15/49) was better than control group [27％ (13/49) and 63％ (31/49)] (all P ＜ 0.05).ESW treatment of persistent heel pain was more efficacious than physical therapy and it could be applied clinically.

Cirugía percutánea en fascitis plantar y espolón calcáneo / Percutaneous surgery plantar fascitis and heel spur

Se realizó un estudio prospectivo tipo serie clínica donde se avaluá la evolución de 12 pacientes (24 pies) quienes presentaban talalgia crónica por fascitis plantar con presencia de espolón calcáneo y fueron tratados con fasciotomía plantar percutánea. La mayoría de los pacientes son femeninos (90 por ciento) y la edad promedio es 40,5 años. Tiempo de seguimiento 12 meses. El resultado final fue valorado por escala análoga visual (EAV) para cuantificar dolor, opinión de paciente y reintegro a actividades habituales. El procedimiento estadístico se hizo con el programa SSPS 12,0 donde se calcularon medidas de tendencias central y de dispersión. El análisis inferencial se realizó con comparación de medidas a través de prueba T student y con la prueba no paramétrica Chi cuadrado. Se reportó 90 por ciento de resultados satisfactorios. La cirugía percutánea del pie en fascitis plantar con espolón calcáneo es un método sencillo y eficaz. Mejora el tiempo quirúrgico y logra el reintegro precoz del paciente a sus actividades habituales.

We realized a trial study where was evaluated 12 pacients (24 foots), 9 women and 3 male, who presented pain heel asociated with plantar fascitis and sprus and were realizaed fasciotomy percutaneus surgery to determine the efectiveness. The results was evaluated with analog visual scale (VAS) both the pain and the daily activities. The SSPS 12,0 statist program was utlized. The inferencial study was done with T student test and Chi square. Most patients were female (90 percent), mean age 40,5 years old. The follow up was twele months. The points in VAS to pain descending to 8,5 to 1,5. Pain was significantly lower at every assessment point as compare to preoperative values (P<0.05). Was reported90 percent of satisfactory results. The fasciotomy percutaneus surgery is a safe, efective and single procedure to treatment the pain heel for plantar Fascitis and calcaneal spurs. Those patients had significantly less postoperative pain and returned to regular activities early.