Name of the Procedure:

Ostectomy, calcaneus; for spur, with or without plantar fascial release

Summary

An ostectomy of the calcaneus is a surgical procedure that involves removing a bone spur from the heel bone. This procedure can be done with or without a release of the plantar fascia, a thick band of tissue that runs along the bottom of the foot.

Purpose

This procedure addresses painful bone spurs on the calcaneus (heel bone) which can cause significant discomfort and difficulty walking. The goals of the procedure are to alleviate pain, improve mobility, and correct any deformity caused by the spur.

Indications

• Chronic heel pain not responsive to conservative treatments such as medication, physical therapy, or orthotic devices.
• Presence of a noticeable calcaneal spur on imaging studies.
• Symptoms including pain upon weight-bearing that interferes with daily activities or productivity.
• Plantar fasciitis unrelieved by less invasive measures.

Preparation

• The patient may be required to fast for several hours before the procedure.
• Adjustments to medications, such as blood thinners, may be necessary.
• Preoperative imaging, such as X-rays or MRI, to accurately locate the heel spur.
• Overall health assessment and blood tests to ensure the patient is fit for surgery.

Procedure Description

1. The patient is administered either general anesthesia or local anesthesia with sedation.
2. A small incision is made at the side of the heel.
3. Specialized surgical tools are used to remove the bone spur from the calcaneus.
4. If necessary, the plantar fascia may be partially cut to release tension.
5. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 1.5 hours.

Setting

The procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Surgeon (specifically, an orthopedic or podiatric surgeon)
• Anesthesiologist or nurse anesthetist
• Surgical nurse or technician
• Post-anesthesia care unit staff

Risks and Complications

• Infection at the surgical site
• Nerve damage leading to numbness or tingling
• Prolonged pain or discomfort
• Blood clots or deep vein thrombosis
• Recurrence of the bone spur
• Delayed wound healing or scarring

Benefits

• Alleviation of chronic heel pain
• Improved ability to walk and perform daily activities
• Potential for quicker recovery compared to untreated prolonged pain.

Recovery

• The patient may need to rest and keep weight off the foot for several weeks.
• Use of crutches or a walker might be necessary immediately post-operation.
• Follow-up appointments to monitor healing and remove stitches.
• Physical therapy may be recommended to regain full mobility.
• Most patients can return to normal activities within 6-8 weeks.

Alternatives

• Non-surgical treatment such as physical therapy, orthotics, and anti-inflammatory medications.
• Corticosteroid injections to reduce inflammation and pain.
• Shockwave therapy can sometimes relieve symptoms without the need for surgery.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-surgery, the patient may experience some discomfort and swelling, which can be managed with prescribed pain medications and ice. Elevating the foot can help reduce swelling, and adhering to post-operative care instructions will aid in a smoother recovery.