Minimally invasive surgery for plantar fasciitis. скачать в хорошем качестве

Minimally invasive surgery for plantar fasciitis.

I will now present how I perform percutaneous, ultrasound-guided surgery for plantar fasciitis in an outpatient setting. The patient is positioned supine. I begin with a hydrodissection by infiltrating lidocaine diluted with saline, both superficial and deep to the plantar fascia. This infiltration helps to separate the muscles as well as the fatty tissue on either side of the fascia. Once the area is secured, I introduce a 16-gauge needle medially, close to the plantar surface, in order to avoid the lateral plantar branch. I then perform back-and-forth movements with the bevel of the needle strictly within the thickness of the fascia, in order to release its pathological medial portion. I stop as soon as the remaining fascia appears healthy, that is, thinner. During this procedure, we also performed a contralateral injection, since the patient had plantar fasciitis on the other side as well, which had so far responded to medical treatment. The procedure is carried out under nitrous oxide. I start with a similar hydrodissection, above and below the fascia, which I observe in transverse view, and then I inject Diprostene around the enthesis of the plantar fascia.