Medial gastrocnemius proximal fasciotomy in patients with chronic plantar fasciitis: a systematic review

Introduction: Plantar fasciitis is the main cause of heel pain in middle-aged patients. In chronic cases, limited ankle dorsiflexión caused by isolated gastrocnemius contracture is considered the main risk factor for suffering it. Therefore, in recent years the number of patients operated on by proximal fasciotomy of the medial gastrocnemius (FPGM) has increased to treat chronic plantar fasciitis.

Material and methods: Systematic review following the PRISMA guidelines. We have carried out a bibliographicg search in Pubmed, Science Direct, Cochrane Library and Web of Science databases. 184 articles wer found. Data extraction was performed using the Covidence software, and a quality and risk of bias analysisi of the included articles was performed base on the Cochrane risk of bias Tool 2.0.

Results: 3 articles were included in the review: 2 randomized clinical trials and 1 cohort study with a total of 138 patients. In the analyzed studies, patients afer proximal fasciotomy of the medial gastrocnemius showed significant improvements in pain and in the AOFAS score with high levels of patient satisfaction. Increases in ankle dorsiflexion angle were found after 12 months of follow-up, with no loss of gastrocnemius strength. The complication rate was low and fewer occured in the proximal fasciotomy compared to plantar fasciotomy.

CITATION  Rev Esp Cir Ortop Traumatol. 2023 Sep 18;S1888-4415(23)00191-1. doi: 10.1016/j.recot.2023.08.017