ABSTRACT
Plantar fasciitis is the most common cause of plantar heel pain. The condition is potentially self-limiting and can respond to conservative treatment, but patients may opt for surgery if the treatments fail. Surgical intervention is associated with potential complications. This study set out to explore the efficacy of the specific nonsurgical intervention offered to treatment-resistant cases in a local clinical setting. The technique involves image intensifier-guided injection of corticosteroid and local anesthetic agents under general anesthesia. Nineteen patients with recalcitrant plantar fasciitis of over 12 months' duration received injections. A simple follow-up questionnaire was given to patients after the procedure that focused on their subjective opinion of any change in their pain. They were also asked if the injection had solved their problems with heel pain. The improvements that the patients reported were found to be statistically significant (P = .012).
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Anesthetics, Local/administration & dosage , Fasciitis, Plantar/drug therapy , Hydrocortisone/analogs & derivatives , Adult , Bupivacaine/administration & dosage , Bupivacaine/analogs & derivatives , Drug Therapy, Combination , Female , Humans , Hydrocortisone/administration & dosage , Image Enhancement , Injections , Levobupivacaine , Male , Middle Aged , Pain Measurement , Patient Satisfaction , Retrospective StudiesABSTRACT
The tendon of flexor pollicis longus angulates at the trapezio-metacarpal joint level. The degree of angulation varies with extent of radial/ulnar deviation (Rack and Ross [1984] J. Physiol. 351:99-110). We report a fibrous pulley at this level that helps stabilize the tendon and facilitates its action. The morphology of the pulley is described. We believe that it has an important role to play in the unique function of the tendon facilitating the movement of the thumb perpendicular to the plane of the thumbnail.
