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Ankle sprains are probably one of the most common sport-related injuries and, although they generally have a benign process and with the appropriate treatment they can heal, more serious ligament injuries can produce a chronic pain linked to instability.
If the treatment with therapy and, occasionally, with insoles or modifying physical activity cannot solve this problem, the reparation of the ankle ligaments is recommended.

The arthroscopy surgery is one of the bigger developments in traumatology in the last century because it allows to treat multiple articular injuries and pathologies using minimal incisions techniques, avoiding the loss of mobility, scars and inflammation that was associated before to articular operations. Among the problems that can be treated with this technique, we find cartilage injuries and the anterior and posterior ankle impingement.

One of the most common causes of heel spur is the plantar fasciitis, sometimes linked to the appearance of heel spur, which is a bone development in the support zone of the heel. The causes can be numerous and the treatment is directed towards eliminate this causes when it is possible by losing weight, limiting physical activity and with physical therapy to improve the pain and retractions by stretching the Achilles tendon and the plantar fascia, applying local therapies to relieve pain and shock waves.
If these treatments fail, surgery is recommended and it means releasing the plantar fascia by open or percutaneous surgery and in some occasions, procedures like releasing the internal calf muscle, when required. Percutaneous surgery has the advantage of being conducted by a minimal incision in the heel by which, besides releasing the plantar fascia, it is possible to eliminate the heel spur if there was one. It does not require hospitalisation and it allows to stand early.

The percutaneous surgery is one of the most important developments in the last few decades regarding foot surgery. This is a technique in which it is possible to correct deformities and other problems with minimal incisions of about 3 or 4 mm, instead of using the traditional 5 or 6 cm incisions, reducing the post-op pain, getting a better aesthetic result and an earlier comeback to the daily activities.
Previously painful procedures, often associated with gross scars are now performed as ambulatory interventions performed with local o regional anesthesia , allowing the partient to make weight bearing from the first postoperative day and leave almost imperceptible scars.

Percutaneous surgery indications

• Bunions—Hallux valgus
• Tailor’s Bunion
• Metatarsalgia
• Plantar fasciitis – heel spur
• Morton’s neuroma
• Hammer toes and other minor deformities in the toes

Advantages

• It does not require hospitalisation
• It is not necessary to implant plates or screws
• It allows walking immediately after the post-op
• A better aesthetic result
• Local or regional anaesthesia
• Less post-op pain

Intraoperative photo Incisions used in percutaneous surgery