Pregledni rad
PLANTAR FASCIITIS
Željko Jeleč
; Opća bolnica „Dr. Ivo Pedišić, Sisak
Tatjana Cicvara-Pećina
; Zavod za radiologiju KB Dubrava, Zagreb,
Hrvoje Klobučar
; Specijalna bolnica za ortopediju i traumatologiju „Akromion“, Krapinske Toplice,
Goran Bićanić
; Klinika za ortopediju KBC Zagreb i Medicinskog fakulteta u Zagrebu, Zagreb
Miroslav Jelić
; Zavod za ortopedska pomagala i rehabilitaciju KBC Zagreb, Zagreb,
Marko Pećina
; Medicinski fakultet Sveučilišta u Zagrebu
Sažetak
Plantar fasciitis is an overuse injury characterized by
pain at the medial tubercle of the calcaneus and/or along
the medial longitudinal arch of the foot. It usually
develops when repetitive and prolonged stress is placed
on plantar fascia, which may cause microtears and/or
partial or total tears of the fascia near its insertion to the
calcaneus. Plantar fascia plays significant role in the foot
biomechanics. It absorbs mechanical forces placed on the
foot and propels foot forward by utilizing the windlass
effect. In deranged foot biomechanics, like in pronation of
the foot, pes cavus, shortened Achilles tendon, extreme
pes planus, etc., additional stress and elongation of plantar
fascia is observed, which the fascia, because of its
anatomy, is unable to compensate. In athletes, plantar
fasciitis is more common in long distance runners and
increased incidence is observed in tennis players,
basketball players and in dancers. It is usually unilateral
whereas in 15% of patients it is bilateral. Clinical findings
include painful foot with pain across the plantar aspect of
the calcaneus. Diagnosis is usually made after anamnesis
and clinical examination. The most painful spot is located
at the medial tubercle of the calcaneus and pain is
aggravated by passive stretching of the fascia. X-rays
could be useful for diagnosing bony spur (calcar calcanei)
and ultrasound and MRI are useful for diagnosing
thickened fascia, bursa or rupture. MRI and scintigraphy
are also useful for differentiating plantar fasciitis and
stress fracture of the calcaneus. For the treatment of the
plantar fasciitis, especially in athletes, custom made
orthothic devices are used for correction of the deranged
foot biomechanics, even for prevention. For conservative
treatment all usual methods are used (physiotherapy,
cryotherapy, stretching exercises, orthoses through the
night, local ultrasound and shock wave therapy and foot
taping). Surgical treatment with endoscopic or open
methods includes release and complete or partial removal
of deranged plantar fascia. Surgical treatment is most
commonly performed in athletes after 6-12 months of
unsuccessful conservative treatment.
Ključne riječi
planatar fasciitis; etiopathogenesis; clinical presentation; diagnostics; treatment
Hrčak ID:
26483
URI
Datum izdavanja:
1.7.2008.
Posjeta: 19.152 *