Autologous blood injection and botulinum toxin for resistant plantar fasciitis accompanied by spasticity.

Abstract

An originally ambulatory 18-yr-old woman with spastic left hemiplegic cerebral palsy developed left plantar fasciitis with a gradual loss of function requiring use of a wheelchair. Her symptoms were resistant to physical therapy. Two hundred units of botulinum toxin A was diluted in 4 mL of saline and injected into the gastrocnemius. Three milliliters of autologous blood was injected into the plantar fascia. She reported decreased pain at 3 days postinjection. At 10 days, she had no pain on walking. Dorsiflexion increased and Ashworth and Tardieu improved. A stretching program was taught and a better-fitting night splint was obtained. At 21 days, she exhibited no pain and increased dorsiflexion. Autologous blood injection combined with botulinum toxin A may be an alternative treatment for resistant plantar fasciitis accompanied by spasticity. Our hypothesis is that chronic plantar fasciitis is a degenerative condition and thus is relieved when a mild inflammatory process is created that leads to healing.

• Authors: Lynne Romeiser Logan, Karl Klamar, Jerry Leon, Wladislaw Fedoriw
• Journal: American journal of physical medicine & rehabilitation (Am J Phys Med Rehabil) Vol. 85 Issue 8 Pg. 699-703 (Aug 2006) ISSN: 0894-9115 [Print] United States
• PMID: 16865027 (Publication Type: Case Reports, Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Adolescent
• Blood Transfusion, Autologous
• Botulinum Toxins, Type A (therapeutic use)
• Cerebral Palsy (complications)
• Combined Modality Therapy
• Fasciitis, Plantar (complications, therapy)
• Female
• Hemiplegia (complications)
• Humans
• Injections, Intramuscular
• Muscle Spasticity (complications, drug therapy)
• Neuromuscular Agents (therapeutic use)
• Pain Measurement
• Splints