Calcaneal spur in Guyana - abstract

One hundred and fourteen women were seen and treated at the Georgetown Hospital in Guyana between 1972 and 1977 for painful heel due to Calcanceal Spur. Calcaneal Spur can be defined as a spike of bone projecting from the medical tubercle of the calcaneum. The presenting symptom in all patients was pain in the heel on getting out of bed in the mornings and aggravated by walking. There is no doubt that this condition is more common in Guyana as compared to the rest of the West Indies. 75 percent of the patients were East Indians and over 70 percent of the women were fat, their weight ranging from 140-200lb. The parity was 5.4 children per woman and nearly all the patients had flat feet. The maximum incidence occurred between the age of 40 and 50 years. It seems that therefore, that calcaneal spur occurred mostly in fat, fertile, females over forty with flat feet. The cause of the pain is thought to be due to chronic plantar fasciitis, the spike of bone being the end result of repeated trauma to the posterior attachment of the plantar fascia at the calcaneum. Symptomatic relief with local injections of steroid lent further credence to this view. 75 percent of patients obtained a cure by plantar fasciotomy and 85 percent of patients by plantar fasciotomy combined with excision of the spur. Histological examination of the plantar fascia showed plantar fibromatosis (AU)

Calcaneal spur in Guyana

The clinical features and management of 114 women with calcaneal spur seen at the Georgetown Hospital, Guyana are described. The condition occurs most commonly in fat, fertile, females over forty with flat feet. It is three times more common in East Indian women. The painful heel is due to a fibrotic response similar to plantar fibromatosis and not to the spur of bone which is the end result of recurrent strain on the plantar fascia combined with excision of the calcaneal spur (AU)

The treatment of talipes calcaneus by tendon transfer in seventeen cases of polio - abstract

Taplipes calcaneus is a deformity of the foot resulting from paralysis of the triceps surae muscle. It produces a very bulbous heel and an unstable foot. The combination of these two factors lead to a very ackward gait. Seventeen cases of talipes calcaneus from the 1957 and 1962 polio epidemics were available for this study. An attempt has been made to treat these cases by the use of tendon transfers. In all these cases there was little choice in the tendon to be transferred as the muscles of the foot were either partially or completely paralysed. Fifteen cases had peroneus longus transfer. In thirteen of these the tendon was transferred directly into the os calcis. The remaining three had tendon transfers into the tend-achilles. Post-operative evaluation of these cases was based on cosmetic appearance of the foot, strenght of contraction of the transferred tendon and the stability of the foot. Of the seventeen cases, there were ten who had marked improvement in the cosmetic appearance of the foot and excellent (grade 5) contraction of the transferred tendon. In five there was fair cosmetic improvement and in two there was very litte. Two cases had only fair (grade 3) contraction of the transferred tendon and four were poor (grade 2). There was a marked improvement in the gait of all these patients due to the improved stability of the foot. This is best borne out by observing these patients walk (AU)