As the doctor himself explains, the plantar fascia is an aponeurosis, a type of ligament that separates the muscles of the sole of the foot from the plantar fat pad. Due to chronic overload, as in the case of people with high-arched feet, overweight people – and even those who wear inappropriate footwear – the fascia suffers micro-tears that do not heal, since being a very poorly vascularized tissue, They end up degenerating and causing chronic pain. The main symptom of plantar fasciitis is the aforementioned heel pain, which appears mainly when walking, decreasing at rest. “Intense pain is characteristic when we get out of bed and put our feet on the floor, pain that improves as the day goes by,” emphasizes De la Varga.

Until a few months ago, the surgical treatment of chronic plantar fasciitis consisted of partially sectioning the degenerated plantar fascia through an incision of between three and four centimeters on the side of the heel. “It is a very aggressive surgery for the foot, with a painful postoperative period and a very long recovery period,” explains the traumatologist. «At CAMDE, being a sports trauma center, we serve athletes, especially runners affected by chronic plantar fasciitis that prevented them from being able to run. It occurred to us to develop a surgical technique that was minimally invasive and that would allow the athlete to return to sports practice soon,” he says.

To do this, the team formed by doctors Vicente de la Varga, Juan Carlos Pérez Frías, Ignacio Pascual and Vicente De la Varga Cebrián developed a method that they describe as “simple and safe” to perform a plantar fasciotomy, which is what this procedure is called. type of ultrasound-guided surgery. “Controlling the surgery using ultrasound allows us, through incisions of just 3 millimeters, to section the plantar fascia with great precision, with minimal damage to the surrounding tissues,” he explains. It is a surgery that does not require stitches and is performed under local anesthesia and in just ten minutes. «The patient leaves the center walking with a crutch, a crutch that will only take a few days. In a couple of weeks he will be able to restart his work or sports life normally,” he says.

A system applicable to other pathologies

Last weekend, this innovative technique was awarded at the annual congress of the Andalusian Society of Traumatology and Orthopedics (SATO), held in Córdoba; although it is not the first time this has happened. The team led by Dr. De la Varga already presented a similar ultrasound-guided technique for the treatment of carpal tunnel syndrome at last year’s congress.

Specifically, it was once again a matter of successfully applying a very non-invasive technique to operate on the aforementioned syndrome, a pathology that reduces mobility and sensitivity to three fingers of the hand, especially the thumb and index finger. The surgery is performed on an outpatient basis under local anesthesia and the entire procedure takes 10 minutes; a situation similar to the system they have devised for plantar fasciitis. The intervention is done with a minimal incision in the patient’s hand, who can return to work or sports activities in less than a week.

The operation consists of a two or three millimeter incision that does not require sutures and allows you to resume work or sports activity in less than a week and with an almost painless postoperative period as there is hardly any wound to the skin, explains Dr. Vicente de la Varga. To do this, a special 2.5 millimeter scissors are used and the carpal tunnel is opened guided by ultrasound.

Carpal tunnel syndrome consists of entrapment of the median nerve in the wrist as it passes under the transverse carpal ligament. Five percent of the Spanish population suffers from it, mostly women between 30 and 50 years old, indicates Dr. De la Varga. It is usually an occupational disease related to repetitive manual activities, although it also appears in other diseases such as hypothyroidism and also affects pregnant women due to fluid retention. This syndrome is characterized by numbness and lack of sensitivity in the first three fingers of the hand, especially the index and thumb, which makes activities that require a fine clamp such as fastening a button or sewing difficult.

With this new technique, designed by this group of traumatologists from Malaga, it is achieved that, as the scar is two or three millimeters, it does not need stitches and, after 24 hours of bandaging, patients can immediately resume their work or your sport with minimal discomfort.