Calcaneal spur in Guyana - abstract

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)