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Rehabilitation Practice and Science

Translated Title

以玻尿酸注射治療足跟脂肪墊症候群：病例報告

Abstract

Plantar fasciitis and heel fat pad syndrome are two of the most common causes of plantar heel pain. Because the clinical symptoms and signs are similar, the differential diagnosis between plantar fasciitis and heel fat pad syndrome is important for proper treatment. Unfortunately, conservative treatment strategies are less effective for plantar heel pain caused by heel fat pad syndrome. We present here a 56-year-old male patient with bilateral plantar heel pain that was especially severe in the left foot. We gave him an injection of 2 ml high-concentration, cross-linked hyaluronic acid into the deep derma of the painful heel pad after conservative treatments failed. The thickness of the left heel pad increased immediately following the injection, but gradually returned to its original thickness 10 days after the injection. Evaluated at the baseline and at 6 months after the injection using ultrasonography and Pun's pain and walking scale, the patient's pain scale changed from secondary grade (severe pain when attempting to walk, preventing all activities) to fifth grade (occasional and slight pain), while the walking scale changed from first grade (bedridden or able to take only a few steps) to third grade (walking short distance, less than one hour). No significant side effects or complications were observed in the two years of follow-up. The patient received a second injection of high-concentration, cross-linked hyaluronic acid into the bilateral plantar heels again due to recurring symptoms 2 years later with good symptom remission again. The characteristic changes of the fat pad in the heel, such as fat pad atrophy and decreased elasticity, may cause plantar heel pain. The result of this casereport potentially indicates that hyaluronic acid injections could be an alternative method to relieve pain and improve gait function in patients with plantar heel pain caused by fat pad changes. Increased thickness in the heel fat pad, increased elasticity, and reduced plantar pressure may account for its effectiveness. Injections of high-concentration, cross-linked hyaluronic acid into the deep derma of the plantar heel may be an effective and safe treatment for plantar heel pain.

Language

Traditional Chinese

First Page

59

Last Page

67

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