A Comparative Study of Gastrocnemius Release and Open Plantar Fasciotomy for chronic Plantar Fasciitis

Background: For chronic plantar fasciitis (CPF), plantar fascia release was traditionally advised, but success rates vary, with risks including lateral column pain, nerve injury, wound complications, and fascia rupture. Gastrocnemius recession at the musculotendinous junction is another technique used for treatment. Objective: This study aimed to compare the results obtained from open plantar fasciotomy (OPF) with those obtained from proximal medial gastrocnemius release (PMGR) in the treatment of chronic PF. Patients and methods: This prospective study was conducted in the Orthopedic Department at Menoufia University Hospitals between April 2022 and May 2024. The sample included 20 patients with chronic PF unresponsive to conservative treatment. Results: A significant improvement in functional scores was achieved in both groups at 3, 6, and 12 months compared to the preoperative status (Repeated measures ANOVA, P = .000). By running a post-hoc analysis, no significant improvement in pain scores was reported with the OPF group in 6- and 12-months follow-up compared to the 3-months follow-up (Bonferroni test, P > .05). On the other hand, a significant improvement was observed between 3 and 6 months in the PMGR group (Bonferroni test, P = .013). Conclusion: PF is often a self-limiting illness, with the majority of patients experiencing complete symptom relief with conservative treatment. PMGR and OPF were useful and safe surgical treatments for CPF patients. Both operations produced positive results in terms of pain, function, satisfaction, and health perception.