August 2011

Ankle foot orthoses assist conservative treatment of retrocalcaneal heel pain

In the moment: O&P

Nonoperative treatment of retrocalcaneal heel pain with stretching and ankle foot orthoses has had an 83% success rate at the University of Tennessee, researchers from that institution reported in July at the annual meeting of the American Orthopaedic Foot & Ankle Society in Keystone, CO.

The investigators reviewed a series of 103 patients seen during an eight-year period who were treated conservatively for retrocalcaneal heel pain, arising from insertional Achilles tendinitis, pretendon bursitis, retrocalcaneal bursitis, and Haglund’s deformity.

Patients’ mean scores on the Foot Function Index fell (indicating a positive change) from 48.4 before treatment to 18.6 after treatment, a statistically significant functional improvement. Only 12 patients were dissatisfied with the nonoperative outcomes and elected to have a surgical procedure.

Patients with exostoses were less likely to improve their FFI scores than those without exostoses. In particular, patients with small (<1 cm) exostoses experienced less improvement than those with larger exostoses. And those with type I and III exostoses demonstrated smaller gains than those with type II or IV (exostoses at the tendinous insertion).

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