Plantar Rupture

Rupture of the plantar fascia induced by glucocorticoids has usually been reported in athletes. However, a case of spontaneous degenerative rupture has been reported in a 72-year-old man who had received four glucocorticoid injections over 1 year for plantar fasciitis (SEDA-21, 418) (277). 

Bressel E, M. P. (n.d.). Biomechanical behavior of the plantar flexor muscle-tendon unit after an achilles tendon rupture. Am J Sports Med, 29(3) 321-326. 

Fig. 16.12 a,b. Clinical tests, a The anterior drawer test (arrows) is carried out by grasping the patient s distal tibia with one hand while pulling the calcaneus anteriorly with the other. When the anterior talofibular ligament is torn, the talus shifts anteriorly, b Thompson s test is carried out by squeezing the calf. If the Achilles tendon is intact, this maneuver produces plantar flexion (arrow). Absence of plantar flexion in this test indicates a rupture of the Achilles tendon... 

Fig.l6.78a-c. Complete rupture of the Achilles tendon, a US scanning technique includes examination of the tendon during plantar and dorsal flexion of the foot to enhance the separation of the torn ends of the Achilles tendon. Arrows, direction of movement. b,c Long-axis 12-5 MHz US images of a torn Achilles tendon obtained during b plantar and c dorsal flexion of foot. The gap (asterisks) between the tendon ends widens with the foot in dorsiflexion... 

Plantar fascia tears are located at the posterior insertion of the fascia. This condition is most often observed in sportsmen who have sustained forceful plantar flexions. The US appearance of plantar fascia rupture is similar to that of plantar fasciitis and the diagnosis relies mainly on clinical and US findings, including focal nodular swelling and a hypoechoic appearance of the fascia (Fig. 17.33e,f). Surgical fasciotomy exhibits similar characteristics (Yu et al. 1999 Yu 2000). The fascia remains markedly thickened with indistinct superficial and deep margins, probably representing perifascial fibrosis (Fig. 17.35). 

Blitz NM, Christensen JC, Ford LA (2002) Plantar plate ruptures of the second metatarsophalangeal joint. J Foot Ankle Surg 41 138-139... 

Yao L, Cracchiolo A, Farahani K et al (1996) Magnetic resonance imaging of plantar plate rupture. Foot Ankle Int... 

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