Effect of Partial Versus Complete Plantar Fasciotomy on the Windlass Mechanism

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Abstract
Eight adult below-knee cadaver specimens were placed in a testing machine and loaded to 350 newtons according to a strict protocol. Arch height and length measurements were obtained in each specimen with the toes resting on the foot plate, dorsiflexed to 30°, and maximally dorsiflexed manually. The plantar fascia was then divided from medial to lateral in one-quarter increments, and the effect on arch height and length measurements was assessed using the same loading protocol. A consistent decrease in the arch-supporting function on sequential sectioning of the plantar fascia was encountered. A less consistent decrease in the arch-supporting function was reflected by the increase in the height of the arch with sequential sectioning of the plantar fascia. The study demonstrates that partial plantar fasciotomy decreases the arch-supporting function of the plantar fascia in addition to weakening the structure. Strict surgical indications for this type of procedure should be maintained.

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