Treatment of persistent painful heel syndrome by corrective calcaneal osteotomy

ABSTRACT

One foot per subject was examined in a control material of 100 individuals, aged 21-65 years, mean 38.7 years, with non-symptomatic heels. Their calcaneus was radiographed in standard lateral and axial projections. The depths of both medial and plantar concavities of the normal calcaneus were measured, and their normal mean and standard deviation obtained. Based on these findings, and according to the radiological deformity of the os calcis, a calcaneal osteotomy was done for thirty one patients [34 heels], aged between 23 and 55 years, complaining of persistent painful heel. All patients were refractory to conservative treatment for at least 6 months prior to operation. They were followed up for an average of 26 months after operation. Complete symptomatic relief was obtained in 24 patients [27 feet]. Four patients had mild pain after long distance walking or running. Wound infection occurred in one case. Sloughing of the skin with exposure of the staples necessitating their removal occurred in another case. Painful neuroma happened in a third ease. It is concluded that calcaneal osteotomy has a beneficial biomechanical and biological effect in selected cases of persistent painful heel that are refractory to conservative treatment