Lui TH. Arch Orthop Trauma Surg 2007 127(4): 265-267. Subtalar arthrodesis was performed after denuding cartilage from both the articular surfaces of the calcaneus and talus. The authors describe an apophyseal injury of the calcaneus in a child that resulted in a compound deformity consisting of three separate exostoses. bone located at the posterior-superior aspect of. It may develop either due to articular surface depression or may occur due to secondary cartilage damage from the initial trauma. [1] Even though recent studies have shown better results with surgical treatment [2-5] and less invasive stabilization systems [3-5], the treatment of calcaneal fractures remains controversial because of the suboptimal results of treatment and the incidence of complications associated with both conservative and surgical methods. swelling around the back of your heel area. 2. This condition is also known as Haglund's deformity, posterior heel spur or, in laymen's terms, pump bump. The patient was symptom free after a 2 year follow-up. Xp1I xcu9g. Lim EVA, Leung JPF. Subtalar arthrodesis for late sequelae of calcaneal fractures: fusion in situ versus fusion with sliding corrective osteotomy. Lui TH. DOI: 10.3827/FAOJ.2010.0311.0002 Corpus ID: 74737897; Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication @article{Sultan2010PlantarEI, title={Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication}, author={Asif Sultan and Tahir Ahmad Dar and Mohd Iqbal Wani and Mubashir Maqbool Wani and Samina Shafi}, journal={The foot and Ankle Online Journal}, year . Complications from non-operative treatment include arthritis, pain, malunion, and stiffness. Exostosis is NOT the same as a bone cyst/benign tumor. (retrocalcaneal bursitis), posterior calcaneal. J Foot Surg 1986 25(2): 146-148. 2 Resident Government Medical College, Srinagar, India 190005, The Foot and Ankle Online Journal, 2010, on Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication, Gaenslen's Split Heel Approach for the Treatment of Chronic Osteomyelitis of the Calcaneus: A series of three cases, Management of an open crush fracture to the foot from a lawnmower injury: A case report, The clinical and patient centered outcomes following surgical correction of tailors bunion in an acute hospital based podiatric surgery service, Fluoroquinolone-induced Achilles tendinopathy A case report and management recommendations, Reconstruction of an Achilles rupture with 12 cm defect utilizing Achilles tendon allograft and calcaneal bone block: A case report, Congenital amniotic band constriction of the proximal tibia: A Yucatan project case report, Distal lower extremity manifestations in spina bifida patients of the Yucatan Peninsula: A 24-year retrospective case series, Management of a dislocated talar dome fracture with ankle arthrodiastasis and open reduction internal fixation: A case report, A case of recurrent hyperostotic macrodactyly. Osteoporsis. Calcaneal spurs can be located at the back of the heel (dorsal heel spur) or under the sole (plantar heel spur). Clin Podiatr Med Surg 2009 26(1):79-90. Associated injuries. This painful condition is often related to the chronic tugging of a tight Achilles tendon on the heel bone. This is the American ICD-10-CM version of M77.32 - other international versions of ICD-10 M77.32 may differ. The spur is often hook-shaped and grows in the direction of the plantar fascia. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, Clinical orthopaedics and related research. The Procedure An incision is made by the bony prominence. Other symptoms associated with these potential . pain when leaning back on your heels. This region of skin was having major contact with the ground during stance phase, and was associated with an antalgic gait style. Diagnosis: Plantar exostosis of right calcaneus. Subtalar joint arthritis causes pain on weight bearing, aggravated by varus or valgus stressing of the subtalar joint without significant tenderness to the lateral aspect of heel with or without radiological evidence. Robinson JF, Murphy GA. Arthrodesis as salvage for calcaneal malunions. DOI: 10.3827/FAOJ.2010.0311.0002 Corpus ID: 74737897; Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication @article{Sultan2010PlantarEI, title={Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication}, author={Asif Sultan and Tahir Ahmad Dar and Mohd Iqbal Wani and Mubashir Maqbool Wani and Samina Shafi}, journal={The foot and Ankle Online Journal}, year . Stapleton JJ, Belczyk R, Zgonis T. Surgical treatment of calcaneal fracture malunions and posttraumatic deformities. An endoscopic lateral calcaneal ostectomy is described, in which the integrity of the soft tissue envelop is preserved and the amount of cartilage debridement needed is accurately determined. red or warm skin on back of heel. It can feel like widespread joint pain. Complications associated with operative treatment include wound dehiscence, infection, arthritis, stiffness, and iatrogenic nerve and tendon injury. . Srinagar, India 190005. Lateral wall exostosis with peroneal tendon irritation. [1] Most of these fractures occur in male industrial workers and lead to significant economic impact because of long-term disability. A. Sultan, T. A. Dar, Mohd Iqbal Wani, M. M. Wani, Samina Shafi. It is a calcification, spur shaped, located at the plantar fascia level under the heel bone (the calcaneus). Rammelt S, Grass R, Zawadski T, Biewener A, Zwipp H. Foot function after subtalar distraction bone-block arthrodesis. Today's podiatrist has the necessary education and training to treat all conditions of the foot and ankle and plays a key role in a keeping America healthy and mobile while helping combat diabetes and other chronic diseases. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3 rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. The patient was managed, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. Exostosis, also called osteoma, is a benign growth of new bone on top of existing bone. Request PDF | On Nov 1, 2010, Asif Sultan and others published Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication | Find, read and cite all the research you need on ResearchGate We present a case of mismanaged, malunited calcaneal fracture in a young male laborer who had an unusual and rare complication of large exostosis on plantar surface of the middle portion of the calcaneus, which to our knowledge has not been reported. 2) Sutures were removed after 3 weeks and a short leg cast was reapplied for 3 months with non-weight bearing for 6 weeks and partial weight bearing for another 6 weeks. This was not the cause of pain in our patient as his heel pad was more firm, harder, thickened, and less mobile than the normal side. We hypothesize that severe crushing force anteriorly and laterally caused collapse of the calcaneal body to the middle, also fracturing the inferior cortex and taking a large bony fragment plantarly which developed into large bony exostosis. . On clinical examination the patients left foot had an irregular scar of 4 cm over the anterolateral aspect of the foot. The. (Fig. A case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3 rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait is presented. These deformities were corrected by resection of, Archives of Orthopaedic and Trauma Surgery. Pathologies > CALCANEAL Spur or Lenoir spur or calcaneal exostosis It is a calcification, spur shaped, located at the plantar fascia level under the heel bone (the calcaneus). E&*jPB SX8=WLcj\= !&`::Drbwp>slmA%||% 17. This is the American ICD-10-CM version of M89.8X7 - other international versions of ICD-10 M89.8X7 may differ. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Enthesopathy is a health concern relating to the connection of joints and ligaments to a bone. Intensive running, wearing unsuitable shoes, overweight, aging, flat feet increase the risk of developing this spur. [6-9], On reviewing the literature for the treatment of symptomatic, malunited calcaneal fractures, the general consensus suggests that resection of impinging bone with isolated subtalar arthrodesis for subtalar joint arthritis yields the best long term results. Plantar calcaneal spurs , or sometimes simply referred to as calcaneal spurs, are a commonly seen finding in radiology practice. 1. [1,2,6-9,17,18] Acute complications include swelling, fracture blisters, and compartment syndromes. This site uses cookies. Barzullah, Srinagar, India 190005. DOI: 10.3827/FAOJ.2010.0311.0002 Corpus ID: 74737897; Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication @article{Sultan2010PlantarEI, title={Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication}, author={Asif Sultan and Tahir Ahmad Dar and Mohd Iqbal Wani and Mubashir Maqbool Wani and Samina Shafi}, journal={The foot and Ankle Online Journal}, year . Excessive and repeated tractions can cause micro lesions on the posterior insertion of the plantar fascia and cause an inflammatory reaction, then a beginning of ossification. M89.8X7 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 0O nCc}5Vj&tK Chin J Traumatol 2010 13(5): 313-315. He had difficulty in walking for the last year. The Journal of bone and joint surgery. pain in calf muscles when running or walking. 22. @mOV_zM@0_&cR^(m2|s}m#.`s&D .ol.VIhBnRQjJM|6~k~=RimooVJ"%lF/A%Oj{Q]hC'Z*> }R5j.cd 12? JBJS 2005 87A (5): 963-973. 5. The study presents the results of calcaneal spur excision by open surgery. PURPOSE OF THE STUDY The plantar calcaneal spur (inferior calcar calcanei) is a frequent source of foot pain. The 2023 edition of ICD-10-CM M77.32 became effective on October 1, 2022. Subtalar fusion after displaced intra-articular calcaneal fractures: Does initial operative treatment matter? Subtalar distractional realignment arthrodesis with wedge bone grafting and lateral decompression for calcaneal malunion. Request a Demo 14 Day Free Trial Buy Now. doi: 10.3827/faoj.2010.0311.0002, The calcaneus is the most frequently fractured tarsal bone, with calcaneal fractures accounting for 65% of all tarsal injuries and approximately 2% of all fractures. Adapted to sport, city and dress shoes, Orthopedic insoles in accordance with the specifications, Realization of personalized plantar orthoses, Payment by credit card / check / bank transfer, CALCANEAL Spur or Lenoir spur or calcaneal exostosis, 10 a.m. to 12 p.m. and from 2 p.m. to 6 p.m. Monday to Friday, Hyper pressure under the 5th metatarsal head. This article looks at how enthesopathy is caused, as well as . Posterior ankle impingement syndrome caused by malunion of joint depressed type calcaneal fracture. 11. Figure 3 Lateral radiograph at 2 years follow-up showing subtalar fusion with staples in-situ. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. 18. Exostosis, also called osteoma, is a benign growth of new bone on top of existing bone. [2] Heel pad pain is the second most common site of pain after pain over lateral aspect of heel after a calcaneal fracture [2] and have thinning with increased mobility of the pad, and a softer, less firm heel pad compared to the normal side. British volume, We carried out a retrospective review of 47 intra-articular fractures of the calcaneum treated by open reduction and internal fixation in 45 patients by a single surgeon between 1993 and 2001. spondyloarthritis. A 19 year-old male, manual laborer, living in tribal hilly area presented to us with pain in left rearfoot with prominent swelling on the plantar surface and anterior part of the heel. View 2 excerpts, references results and background, Knee Surgery, Sports Traumatology, Arthroscopy. The. [10-23] Moreover, some surgeons also do endoscopic calcaneal ostectomies for calcaneofibular impingement with good results. Various procedures have been described for removing a retrocalcaneal exostosis. <> Achilles Heel Spur (retrocalcaneal exostosis) Achilles bone spurs occur at the back of the heel, where the Achilles tendon attaches the bone. A lateral approach with sharp dissection to raise a full thickness flap from skin to periosteum was performed. Subtalar arthrodesis following calcaneal fracture. 7. He had sustained a crushed wound over the left foot which was accompanied by severe pain and the inability to walk. He had suffered a crushing injury to his left foot while at work in his native place when a heavy stone fell on his left foot from the antero-lateral aspect. There is clear evidence that appropriately indicated procedures are effective in terms of pain alleviation, correction of deformity, and improved function, however, longterm outcomes may improve the acceptability to jointpreserving osteotomies, subtalar arthrodesis with the VIRA implant and subt alar distraction osteogenesis. stiffness. 9. spur, and/or Achilles tendinitis. 3. An endoscopic lateral calcaneal ostectomy is described, in which the integrity of the soft tissue envelop is preserved and the amount of cartilage debridement needed is accurately determined. with "prominence of a bursal projection". JBJS 2010 92B(5): 693-700. the calcaneus. A prospective study. Figure 1A and 1B Lateral (A) and axial (B) view radiographs showing large plantar exostosis, loss of Bohlers angle and subtalar arthritis with normal tibiotalar alignment. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. Osteosynthesis of displaced intra-articular fractures of the calcaneum: a long-term review of 47 cases. It can occur in many parts of the body. JBJS 1993 75A: 331-341. 15. 12. Late complications include arthritis, malunion, lateral exostosis, calcaneofibular abutment, tendon impingement, heel pad problems and reflex sympathetic dystrophy. What is a heel spur feel like? Foot Ankle Clin 2007 12(1): 125-135. 10. Myerson MS, Quill GE Jr. Late complications of fractures of the calcaneus. Accepted: October, 2010 Epidemiology Plantar calcaneal spurs tend to usually occur in older men and women and may be related to obesity, osteoarthritis and current or previous heel pain. Its role is to underpin the arch of the foot in order to work as a cushion. (Fig.1A and 1B) The patient was managed operatively under spinal anesthesia. 4. The authors describe an apophyseal injury of the calcaneus in a child that resulted in a compound deformity consisting of three separate exostoses. A technique to resect the offending posterior calcaneal bone spike to relieve the posterior ankle impingement pain is described. These develop from the undersurface of the calcaneus in patients with injuries to the plantar cortex. 6. Radnay CS, Clare MP, Sanders RW. JBJS 2010 92A: 32-43. Foot Ankle Clin 2002 7(1): 107-120. H=44W$a|h ~Y"a`lE Cs'p [r&U e"kGKU"~VQ8(ZcT__^Isg_WW}'>~G/~W~{/VB}~V_? These are as a consequence of proliferative bony changes at the origin of planter fascia. The patient presented with bony swelling on the sole of the foot with a painful limp and was managed operatively by excision of the exostosis with subtalar arthrodesis. (Fig.3) The patient had returned to his pre-injury employment as manual laborer and the result was deemed good. The spur is thought to be a result of the biomechanical fault and an incidental finding when associated with a painful plantar heel. 4rL@\s $ v!2 -R|sG((c\h$}CPFt;U@ Q*2^3}.kQ:d k-5u`0lCI7W[ These deformities were corrected by resection of, Archives of Orthopaedic and Trauma Surgery. Subscribe to Codify by AAPC and get the code details in a flash. Lateral exostosis usually develops after malunion of calcaneal fractures and is a very common complication. American volume. Hernanz Gonzlez Y, Daz Martn A, Jara Snchez F, Resines Erasun C. Early results with the new internal fixator systems LCP and LISS: a prospective study. Mubashir Maqbool Wani1 , Samina Shafi2, The Foot and Ankle Online Journal 3 (11): 2. The patient was managed, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. It may be associated. The plantar fascia is a fibrous tissue similar to a tendon that links the heel to the forefoot. At 2 years follow-up the patient was pain free with no limp and had a good subtalar fusion. Clin Ortho Related Research 2001 391:7-16. The goal of retrocalcaneal exostosis surgery is to remove the extra bone, remove any scar tissue and damaged tendon, repair tendon tissue, alleviate pain, allow a return to normal shoes, and help to allow a return to desired activities. Key words: Calcaneus, fracture, complications, plantar exostosis, exostectomy, subtalar arthrodesis. Post-traumatic arthritis after intra-articular calcaneal fractures may affect the subtalar or calcaneocuboid joint. Retro Calcaneal Exostosis. Written informed consent was obtained from the patients guardian for publication of this case report and accompanying images. 6% (132/2119) 4. In this case there is an enlargement of the posterior calcaneum, which results in a fraying of the achilles tendon on the calcaneum. The 2023 edition of ICD-10-CM M89.8X7 became effective on October 1, 2022. This could be at the tip or side or through the top of the toe if the nail is removed.This procedure requires stitches. Complications of intraarticular calcaneal fractures. Minimally invasive plate internal fixation for calcaneal fractures. After three months of sustained injury, the patient began to walk with a limp and also had noticed hard swelling under the heel. There is no conflict of interest related to this article. There is clear evidence that appropriately indicated procedures are effective in terms of pain alleviation, correction of deformity, and improved function, however, longterm outcomes may improve the acceptability to jointpreserving osteotomies, subtalar arthrodesis with the VIRA implant and subt alar distraction osteogenesis. (Fig.1) Our result was good with pain free arthrodesis of the subtalar joint. Endoscopic lateral calcaneal ostectomy for calcaneofibular impingement. Intermediate to long-term results of a treatment protocol for calcaneal fracture malunions. [15]. Quick response from 10 a.m. to 12 p.m. and from 2 p.m. to 6 p.m. Monday to Friday, Telephone interview with an Orthopedist-Orthotist, Massage cream for heels with essential oil wintergreen scented Bio Huang PJ, Fu YC, Cheng YM, Lin SY. American volume. He had always had difficulty in walking afterwards due to pain in the hind foot on weight bearing and abnormal prominence under the heel. There were no post operative complications. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causin. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. By clicking accept or continuing to use the site, you agree to the terms outlined in our. JBJS 2000 82A: 225-250. The pain is sharp, located under the heel which makes walking difficult. Clare MP, Lee WE 3rd, Sanders RW. Easley ME, Trnka HJ, Schon LC, Myerson MS. Isolated subtalar arthrodesis. Shan SL, Xu JL, Yao SZ, Yu GS, Liu YQ. 3% (63/2119) 5. Percutaneous reduction and fixation of displaced intra-articular calcaneus fractures. There was no cartilaginous cap on the exostosis. Makki D, Alnajjar HM, Walkay S, Ramkumar U, Watson AJ, Allen PW. Sanders R, Fortin PT, Walling, AK. Calcaneus fractures are the most common fractured tarsal bone and are associated with a high degree of morbidity and disability. Sanders R. Current concepts review: Displaced intraarticular fractures of the calcaneus. Manasseh N, Cherian VM, Abel L. Malunited calcaneal fracture fragments causing tarsal tunnel syndrome: a rare cause. 23. The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. The authors introduce a simplified technique to surgically excise a retrocalcaneal Foot Ankle Surg 2009 15(4): 207-209. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. Common types of exostoses include bone spurs, which are bony growths also known as osteophytes. Complications of intra-articular fractures of the calcaneus. J Trauma 1998 45(4):729-737. Knee Surg Sports Traumatol Arthrosc 2008 16(7): 687-689. Pathology The proper CPT code for correcting a. Haglund's deformity depends on what specifically. This injury healed in 4 weeks, but he still was unable to walk for another two months. - Wearing EPITAL insoles (with arch support to take the stress off the plantar fascia, and of course avoiding the painful area to relieve the pain) anti calcaneal spur; - Focus on wearing shoes with heels of about 2 cm. Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. 14. Email-drasifsultan@yahoo.com, 1Government Hospital for Bone and Joint Surgery, Barzullah. Reconstructive osteotomy of the calcaneus with subtalar arthrodesis for malunited calcaneal fractures. This was indicated for painful subtalar arthritis with normal heel height and normal tibiotalar alignment. %PDF-1.3 Abend L, Berstein DA, Wagreich C. Post-traumatic heel deformity. By clicking accept or continuing to use the site, you agree to the terms outlined in our, Plantar Exostosis in a Malunited Calcaneal Fracture: A rare complication. This pain has been attributed to crushing of the heel pad during injury. Symptoms of heel spurs can include: sharp pain like a knife in the heel when standing up in the morning. by Asif Sultan1 ,Tahir Ahmad Dar1 ,Mohd Iqbal Wani1 , A ligament or a tendon affected at the area where it is attached to the bone. A large plantar exostosis was excised along with associated surrounding bursa. When the exostosis is covered with cartilage, it's called an osteochondroma. Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, Clinical orthopaedics and related research. What is the lump on my heel? Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. In this article, the current thinking regarding the treatment of these very difficult fractures will be reviewed. A Haglund's deformity is a prominence of. An exostosis. Range of motion at the subtalar joint was restricted and painful with increased heel width and no varus or valgus deformity of heel. X-ray revealing the presence of calcaneal spur. These procedures require partial or complete detachment of the insertion of the Achilles tendon and ultimate resection of the exostosis. loss of movement . Enthesopathy can also be a symptom of an underlying condition. % Dr. Heath performs the procedures in an outpatient setting at a state of the art facility. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. If this is from under the toe nail it may be referred to as a subungual exostectomy. 20. The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. In our patient, the plantar exostosis was on the plantar surface of calcaneus in the middle third of the calcaneus, well anterior to the origin of plantar fascia, thus being a rare inferior surface exostosis rather than heel exostosis. This includes: psoriatic arthritis. An exostosis is an extra growth of bone that extends outward from an existing bone. Complications of calcaneal fractures occur in the acute and late stages and after operative or non-operative treatment. Calcaneus malunion and nonunion. British volume, We carried out a retrospective review of 47 intra-articular fractures of the calcaneum treated by open reduction and internal fixation in 45 patients by a single surgeon between 1993 and 2001. [23] This procedure of isolated subtalar arthrodesis has been well documented with good results, [11-14, 23] and is consistent with our case. Retrocalcaneal exostosis refers to the formation of a bony prominence at the back of the heel bone called the calcaneus. J Orthop Trauma 2010 24(8): 466-472. A technique to resect the offending posterior calcaneal bone spike to relieve the posterior ankle impingement pain is described. Orthop Trans 1991 15: 656. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3 rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. We present a case of malunited calcaneal fracture with a rare complication of an exostosis in the middle 3rd of the plantar surface of calcaneus which clinically produced a large bony swelling on the sole of the foot causing pain and abnormal gait .This type of plantar calcaneal exostosis to our knowledge has not been previously reported. [2]. Packaging: 1 pair The diagnosis is an enthesitis with spur. JBJS 2004 86B(5): 659-668. x}eu{o;}"[yFD`yr;HO d H,)V}9FUVVJlZ Wop"vE^|DR~+NP\o|5? 21. Its role is to underpin the arch of the foot in order to work as a cushion. Though the method of sliding corrective osteotomy does not provide much improvement to the talus declination angle, it is suitable for those patients with a banana-shaped calcaneus malunion, and if the patient has prominent anterior ankle pain caused by tibiotalar impingement, a distraction subtalar arthrodesis would be more appropriate. This calcaneal spur can be revealed most of the time by X-ray. Figure 2 Immediate post operative lateral radiograph after removal of exostosis and subtalar arthrodesis. 5 0 obj [+tgD}oz~O`sNzRXPaHSAC*)>^bd9;3ZQxvPB!JY'tBhzi(X(;: M~NKY}M#]yZe`,_m 6Hg3hT'l-cEZjHSb&:\XH%kpmR`cw4j]KJA%PGV+L@Cr JBJS 2000 82A (5): 613-624. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. m@2qBS"^ 1 8 ONLhrKy `:9k~ ^\X pI8T =Z U*' Aklou}l9)XOA50k |E)17"5/P +SFHKk=ln>z{hQM Exostosis can be painless, or it can cause severe pain and require surgical removal. joint space narrowing. Current reasoning is that abnormal biomechanics (excessive or abnormal pronation) is the prime etiological factor for a painful plantar heel and inferior calcaneal spur. Calcaneal fractures are very common and are associated with many complications irrespective of the treatment method chosen. 8. When the exostosis is covered with cartilage, it's called an. stream JAPMA 2004 94(4): 382-388. 13. 16. It can occur in many parts of the body. inversion and plantar flexion of the foot cause avulsion of the bifurcate ligament. In this article, the current thinking regarding the treatment of these very difficult fractures will be reviewed. Subtalar arthritis. It covers the indication, surgical approach, postoperative care, and presents the results reported at least one yea ICD-10-CM Code for Calcaneal spur, right foot M77.31 ICD-10 code M77.31 for Calcaneal spur, right foot is a medical classification as listed by WHO under the range - Soft tissue disorders . Address correspondence to: Asif Sultan , Government Hospital for Bone and Joint Surgery. The plantar fascia is a fibrous tissue similar to a tendon that links the heel to the forefoot. Published: November, 2010, ISSN 1941-6806 DeWall M, Henderson CE, McKinley TO, Phelps T, Dolan L, Marsh JL. He was managed locally, only for wound care and had no proper medical or orthopedic consultation. M77.32 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. I read somewhere years ago the same thing you mentioned - 'bossing' should point you to 'removal of bone or excess bone' as in 'part of the bone' as in 28122. Acta Orthop Belg 2007 73(1): 60-69. Posterior Calcaneal Spur/ Insertions Tendinopathy / Bursitis - General points A special form of chronic achilles tendon pain is the posterior calcaneal spur, often referred to as Haglund exostosis. ?w?kG7;A?o~p?yt_K~_?/[_O?s}~FdU_e3f[y@aD{b/$,= ]1.Y}=_R8Xp=|IT~Fod Figure 2 Immediate post operative lateral radiograph after removal of exostosis and subtalar arthrodesis. Though the method of sliding corrective osteotomy does not provide much improvement to the talus declination angle, it is suitable for those patients with a banana-shaped calcaneus malunion, and if the patient has prominent anterior ankle pain caused by tibiotalar impingement, a distraction subtalar arthrodesis would be more appropriate. The Journal of bone and joint surgery. There was a prominent bony projection on the plantar surface over the anterior aspect of heel which was tender to touch, with thick, firm, and hypertrophic overlying skin. This bony prominence causes difficulty in wearing shoes, tenderness and pain. Increased awareness of these complications and their prevention will aid the practitioner in decision-making and result in better treatment outcomes for this fracture. The Journal of bone and joint surgery. 19. In our patient, operative intervention was performed using a lateral approach as both inferior wall exostectomy (resection of exostosis)[10] and isolated subtalar arthrodesis [11-13] were performed using a single incision. The Journal of bone and joint surgery. Increased awareness of these complications and their prevention will aid the practitioner in decision-making and result in better treatment outcomes for this fracture. Reddy V, Fukuda T, Ptaszek AJ. The patient was managed operatively by exostectomy with subtalar arthrodesis and had a good result at 2 years follow-up. The exostosis was used as graft material and fixed with two staples and a short leg cast was applied after closure. Relief of pain or deformity by removal of prominence of bone (exostosis). Heel exostosis (bony calcaneal spurs) sometimes develop after injury and may also cause chronic heel pain. Romash MM. Packaging: 1 bottle of 50ml, Insoles for calcaneal spur Chen YJ, Huang TJ, Hsu KY, Hsu RW, Chen CW. Walter JH Jr, Rockett MS, Goss LR. BUT - look at the CPT section for leg and ankle joints. Foot Ankle Int 1999 20(3): 166-170. 30 related questions found. Clin Orthop Relat Res 1993 (290): 157-167. If, despite wearing the insoles, the pain is still present after several weeks, go see your doctor. View 2 excerpts, references results and background, Knee Surgery, Sports Traumatology, Arthroscopy. Some of these cookies are essential to the operation of the site, while others help to improve your experience by providing insights into how the site is being used. Radiographic evaluation showed malunited calcaneal fracture with reduced Bohlers angle, subtalar arthritis, minimally increased heel width and a large exostosis on the plantar surface of calcaneus. 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