Heel overload associated with heel cord insufficiency

Margaret M Chilvers, Eric S. Malicky, John G. Anderson, Donald R. Bohay, Arthur Manoli

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Heel cord lengthening is a common component of foot and ankle surgery. If the tendon is anatomically or functionally over lengthened patients may develop plantarflexion weakness and heel overload problems such as symptomatic plantar heel callosities and heel ulceration. Methods: Nine patients who developed heel overload or heel ulcer after a heel cord lengthening or an irreparable rupture were identified. Initial foot injury, risk factors, treatment, and followup were reviewed. Results: Five of the nine patients had diabetes and an insensate heel. The ulcer healed in two of five patients with a dorsiflexion stop brace, two with a tendon transfer, and one required a below knee amputation. There were four patients with heel overload with normal sensation and no diabetes. One improved with strengthening exercises, two with tendon transfer, and one required a below knee amputation. Conclusions: Heel cord insufficiency can lead to an overload callus or a heel ulcer. Patients with diabetes and an insensate heel are at highest risk, but this problem also can occur in patients with normal sensation. Obesity and ipsilateral first toe amputation also may be risk factors.

Original languageEnglish (US)
Pages (from-to)687-689
Number of pages3
JournalFoot and Ankle International
Volume28
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Fingerprint

Heel
Amputation
Tendon Transfer
Ulcer
Knee
Callosities
Foot Injuries
Braces
Bony Callus
Toes
Ankle
Tendons
Foot
Rupture
Obesity
Exercise

Keywords

  • Achilles tendon
  • Diabetic foot
  • Heel ulcer

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Chilvers, M. M., Malicky, E. S., Anderson, J. G., Bohay, D. R., & Manoli, A. (2007). Heel overload associated with heel cord insufficiency. Foot and Ankle International, 28(6), 687-689. https://doi.org/10.3113/FAI.2007.0687

Heel overload associated with heel cord insufficiency. / Chilvers, Margaret M; Malicky, Eric S.; Anderson, John G.; Bohay, Donald R.; Manoli, Arthur.

In: Foot and Ankle International, Vol. 28, No. 6, 06.2007, p. 687-689.

Research output: Contribution to journalArticle

Chilvers, MM, Malicky, ES, Anderson, JG, Bohay, DR & Manoli, A 2007, 'Heel overload associated with heel cord insufficiency', Foot and Ankle International, vol. 28, no. 6, pp. 687-689. https://doi.org/10.3113/FAI.2007.0687
Chilvers, Margaret M ; Malicky, Eric S. ; Anderson, John G. ; Bohay, Donald R. ; Manoli, Arthur. / Heel overload associated with heel cord insufficiency. In: Foot and Ankle International. 2007 ; Vol. 28, No. 6. pp. 687-689.
@article{0ec607a80e074d04a59857ac7f10a7bb,
title = "Heel overload associated with heel cord insufficiency",
abstract = "Background: Heel cord lengthening is a common component of foot and ankle surgery. If the tendon is anatomically or functionally over lengthened patients may develop plantarflexion weakness and heel overload problems such as symptomatic plantar heel callosities and heel ulceration. Methods: Nine patients who developed heel overload or heel ulcer after a heel cord lengthening or an irreparable rupture were identified. Initial foot injury, risk factors, treatment, and followup were reviewed. Results: Five of the nine patients had diabetes and an insensate heel. The ulcer healed in two of five patients with a dorsiflexion stop brace, two with a tendon transfer, and one required a below knee amputation. There were four patients with heel overload with normal sensation and no diabetes. One improved with strengthening exercises, two with tendon transfer, and one required a below knee amputation. Conclusions: Heel cord insufficiency can lead to an overload callus or a heel ulcer. Patients with diabetes and an insensate heel are at highest risk, but this problem also can occur in patients with normal sensation. Obesity and ipsilateral first toe amputation also may be risk factors.",
keywords = "Achilles tendon, Diabetic foot, Heel ulcer",
author = "Chilvers, {Margaret M} and Malicky, {Eric S.} and Anderson, {John G.} and Bohay, {Donald R.} and Arthur Manoli",
year = "2007",
month = "6",
doi = "10.3113/FAI.2007.0687",
language = "English (US)",
volume = "28",
pages = "687--689",
journal = "Foot and Ankle International",
issn = "1071-1007",
publisher = "AOFAS - American Orthopaedic Foot and Ankle Society",
number = "6",

}

TY - JOUR

T1 - Heel overload associated with heel cord insufficiency

AU - Chilvers, Margaret M

AU - Malicky, Eric S.

AU - Anderson, John G.

AU - Bohay, Donald R.

AU - Manoli, Arthur

PY - 2007/6

Y1 - 2007/6

N2 - Background: Heel cord lengthening is a common component of foot and ankle surgery. If the tendon is anatomically or functionally over lengthened patients may develop plantarflexion weakness and heel overload problems such as symptomatic plantar heel callosities and heel ulceration. Methods: Nine patients who developed heel overload or heel ulcer after a heel cord lengthening or an irreparable rupture were identified. Initial foot injury, risk factors, treatment, and followup were reviewed. Results: Five of the nine patients had diabetes and an insensate heel. The ulcer healed in two of five patients with a dorsiflexion stop brace, two with a tendon transfer, and one required a below knee amputation. There were four patients with heel overload with normal sensation and no diabetes. One improved with strengthening exercises, two with tendon transfer, and one required a below knee amputation. Conclusions: Heel cord insufficiency can lead to an overload callus or a heel ulcer. Patients with diabetes and an insensate heel are at highest risk, but this problem also can occur in patients with normal sensation. Obesity and ipsilateral first toe amputation also may be risk factors.

AB - Background: Heel cord lengthening is a common component of foot and ankle surgery. If the tendon is anatomically or functionally over lengthened patients may develop plantarflexion weakness and heel overload problems such as symptomatic plantar heel callosities and heel ulceration. Methods: Nine patients who developed heel overload or heel ulcer after a heel cord lengthening or an irreparable rupture were identified. Initial foot injury, risk factors, treatment, and followup were reviewed. Results: Five of the nine patients had diabetes and an insensate heel. The ulcer healed in two of five patients with a dorsiflexion stop brace, two with a tendon transfer, and one required a below knee amputation. There were four patients with heel overload with normal sensation and no diabetes. One improved with strengthening exercises, two with tendon transfer, and one required a below knee amputation. Conclusions: Heel cord insufficiency can lead to an overload callus or a heel ulcer. Patients with diabetes and an insensate heel are at highest risk, but this problem also can occur in patients with normal sensation. Obesity and ipsilateral first toe amputation also may be risk factors.

KW - Achilles tendon

KW - Diabetic foot

KW - Heel ulcer

UR - http://www.scopus.com/inward/record.url?scp=34249789862&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34249789862&partnerID=8YFLogxK

U2 - 10.3113/FAI.2007.0687

DO - 10.3113/FAI.2007.0687

M3 - Article

VL - 28

SP - 687

EP - 689

JO - Foot and Ankle International

JF - Foot and Ankle International

SN - 1071-1007

IS - 6

ER -