[Aponeurotomy and degenerative lesions of the plantar aponeurosis. Contribution of magnetic imaging].

PURPOSE OF THE STUDY

Talalgia are frequent. Their etiologies are various and diagnosis is sometimes difficult.

MATERIAL

From 1980 to 1993, 12 cases of degenerative lesions of plantar aponeurosis were treated surgically. M.R.I. revealed 6 chronic aponeurositis and 6 old tears. The treatment was an aponeurectomy with resection of calcaneal spine after a conservative treatment for several months. The histological examination found inflammation in all cases (aponeurositis or rupture), a calcification of aponeurosis, a cartilaginous metaplasia and fibromatosis.

METHODS

Patients were evaluated at a minimum of 2 years follow-up and a maximum of 6 years. The post-operative results were estimated using 3 criteria: pain disappearance, results on the foot static, patients functional activity.

RESULTS

Global score was : 9 very good and good results, one fair result and 2 bad results. The M.R.I. realized at the time of revision revealed a good healing of plantar aponeurosis in 5 cases, defect in 1 case, inflammation in 3 cases and defect associated with inflammation in 3 cases.

DISCUSSION

Surgical treatment can be suggested in failures of talalgia conservative treatment. Degenerative injuries of plantar aponeurosis, as rupture or aponeurositis may take advantage of an aponeurectomy. Short term results show pain disappearance in 75 per cent of cases without modification of the plantar arch.

CONCLUSION

M.R.I. allows to explain exactly the origin of talalgia. After a failure of conservative treatment, some talalgia may take advantage of an aponeurectomy.