Plantar fascia rupture

 

Etiology

 

Plantar fasciitis / cortisone injections

Athletes - soccer players, NFL

 

Mosca et al Foot Ankle Spec 2022

- systematic review of 155 feet

- 8% spontaneous

- 89% associated with plantar fasciitis

- 84% associated with cortisone injection

 

History

 

Sudden onset acute during athletics

 

Examination

 

Focal tenderness

+/- loss longitudinal arch

 

Pathology

 

Often incomplete

 

Saxena et al AJSM 2004

- 18 athletes with plantar fascia rupture

- all but 2 were ruptures of medial band

 

MRI

 

Tearing of insertion of plantar fascia

 

Management

 

Nonoperative

 

Indication

 

Incomplete tears

 

Technique

 

Rigid boot 2 - 6 weeks

 

Results

 

Saxena et al AJSM 2004

- 18 athletes with plantar fascia rupture

- all incomplete tears

- all treated non operatively

- return to sport at mean 2 - 26 weeks

 

Operative

 

Indication

 

Complete tear

Loss of longitudinal arch

 

Results

 

Schaarup et al J Foot Ankle Surg 2020

- 5 athletes with total rupture of plantar fascia

- 2 treated with surgery and returned to sport at 12 months

- better results with surgery