Calcaneal Osteotomy for Recalcitrant Planter Fasciosis

February 22, 2026 updated by: George Botros Sayed Mosa, Assiut University

Evaluation of Results of Calcaneal Osteotomy in Adult Patient With Recalcitrant Planter Fasciosis: Short Term Results

The aim of this study is to assess the efficacy of planter displacement calcaneal osteotomy for intractable plantar fasciosis by decreasing the tension of the plantar fascia around the calcaneal attachment while keeping the plantar fascia intact.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Plantar fasciosis is a leading cause of heel pain in adults and represents a degenerative rather than inflammatory condition of the plantar fascia. Most cases resolve with conservative measures; however, up to 10-15% remain symptomatic and may require surgical intervention.

Plantar fascia release-either open or endoscopic-remains a standard surgical option for recalcitrant cases. However, this procedure may compromise foot biomechanics. Recent biomechanical and clinical studies have demonstrated that partial or complete release reduces longitudinal arch height and increases midfoot strain, particularly when more than 50% of the fascia is divided. Such alterations in load distribution can result in lateral column overload, metatarsalgia, and sinus tarsi pain. Endoscopic release has also been associated with medial arch reduction and the development of lateral column symptoms within months postoperatively, further highlighting these risks. Additionally, comparative studies report wound complications, nerve irritation, and recurrence of heel pain in a notable subset of patients undergoing plantar fasciotomy. Up to 50% of patients may experience persistent or recurrent pain following the procedure.

Entrapment of the first branch of the lateral plantar nerve (Baxter's nerve) is another under-recognized cause of chronic heel pain, often coexisting with or mimicking plantar fasciosis. Decompression of Baxter's nerve, either alone or combined with limited plantar fascia release, has been shown to improve outcomes in resistant cases.

Given these limitations, calcaneal osteotomy has emerged as alternative surgical strategies. By altering the mechanical axis of the calcaneus and inducing localized bone remodeling, these techniques aim to unload the plantar fascia insertion without compromising arch stability. Early reports suggest that calcaneal osteotomy, particularly when combined with Baxter's nerve release, may offer superior pain relief and functional recovery in recalcitrant plantar fasciosis.

Study Type

Interventional

Enrollment (Estimated)

11

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • All adult patients with age range from 18 to 65 years with unilateral or bilateral planter fasciosis after clinical and radiological diagnosis confirmation, who failed conservative treatment for at least 6 months or recurrent cases.
  • MRI & US proof of planter fasciosis showing thickness of planter fascia >4mm

Exclusion Criteria:

  • All other causes of heel pain including polyneuropathy, planter fascia rupture, seronegative arthropathies, rheumatoid arthritis in bilateral cases, abscess or neoplasm affecting the soft tissue, and bone occult fracture or infection.
  • Age groups below 18 years old and above 65 years old.
  • Plantar fasciosis cases having pes planus with diffuse foot pain not only localized to the planter fascia origin (the medial tubercle of the calcaneus - a bony prominence on the inferomedial aspect of the calcaneus).
  • Diabetic patients
  • Primary tarsal tunnel syndrome (not presented secondary to a deformity or another cause)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Calcaneal osteotomy
Calcaneal osteotomy skin incision will be oblique and directed from the infero-posterior edge of the lateral malleolus to the inferior edge of the calcaneal body, and you should be careful not to cause injury to the sural nerve. Osteotomy of the exposed lateral wall will be performed from 1 cm anterior to the calcaneal attachment of the plantar fascia to 1 cm anterior to the calcaneal attachment of the Achilles tendon. After the osteotomy, approximately 5 mm plantar displacement of the proximal fragment, which include attachment of the plantar fascia, will be performed. Patients with a pronated foot before surgery will have an additional approximately 5 mm medial displacement of the proximal fragment simultaneously to correct malalignment. Fixation after the osteotomy will be performed under an image intensifier using one or two cannulated cancellous screws 7.3 mm in diameter, which will be inserted from the infero-medial of the calcaneal tuberosity to the distal fragment.
Procedure: Calcaneal osteotomy for recalcitrant planter fasciosis
planter displacement calcaneal osteotomy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
AOFAS score
Time Frame: 6 months after surgery
the change in the American Orthopaedic Foot and Ankle Society Ankle Hindfoot Scale (AOFAS score) score of 100 points. Higher score means better function with less pain and good alignment
6 months after surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
VAS
Time Frame: 12 months
Pain assessment measured pre & post-operative by VAS (Visual Analog Scale) at 12 months
12 months
Foot pressure
Time Frame: 12 months
Foot pressure measurement pre & post-operative
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 1, 2026

Primary Completion (Estimated)

October 1, 2027

Study Completion (Estimated)

October 1, 2028

Study Registration Dates

First Submitted

February 22, 2026

First Submitted That Met QC Criteria

February 22, 2026

First Posted (Actual)

February 27, 2026

Study Record Updates

Last Update Posted (Actual)

February 27, 2026

Last Update Submitted That Met QC Criteria

February 22, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • osteotomy in planter fasciosis

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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