[Open Heel Spur Surgery - Our Experience].

PURPOSE OF THE STUDY The plantar calcaneal spur (inferior calcar calcanei) is a frequent source of foot pain. The study presents the results of calcaneal spur excision by open surgery. It covers the indication, surgical approach, postoperative care, and presents the results reported at least one year after the surgery. MATERIAL AND METHODS The group consists of 42 heel spurs in 41 patients operated on in the period 2000-2016. The mean age was 44.5 years, with the age range 37-75 years. In 18 cases the surgery was performed on the right side, in 24 cases on the left side, the group was composed of 24 women and 17 men. Difficulties were suffered for the period of 8 months to 10 years before the surgery, the conservative treatment always continued for at least 6 months. The patients were assessed by the AOFAS questionnaire and the VAS score preoperatively and at 6 and 12 months postoperatively. Also, control radiographs were used to assess any potential recurrence. The surgical approach, the surgery per se and the postoperative care are described in detail. RESULTS The AOFAS score was 56 (45-75) preoperatively, 89.8 (82-98) at 6 months postoperatively and 90.4 (82-98) at one year after the surgery. The VAS score was 7 (5-9) preoperatively, 2 (0-4) at 6 months postoperatively, and 2 (0-3) at one year after the surgery. The average operative time was 35 minutes (20-50). The average length of stay in hospital was 3.8 days (2-5). The average duration of postoperative treatment was 16 weeks (12-26). Early complications involved one case of paresthesia experienced along the outside of the foot, which faded away. In one case the control radiograph at a one-year follow-up revealed recurrence of a heel spur. DISCUSSION Removal of plantar calcaneal spur is indicated after the conservative treatment options have been exhausted. By open surgery, results comparable to arthroscopy are achieved, but with fewer complications, while providing a better view of the surgical wound, a possibility to perform additional interventions in this region under visual control, a considerably lower exposure to X-ray, and it is also inexpensive. The scar is of minimum size and comparable to those after arthroscopy. CONCLUSIONS Heel spur surgery is a safe procedure with minimum complications. Nonetheless, it is indicated only once the conservative treatment options have been exhausted. Key words:calcaneus bone, plantar calcaneal spur.