DEVELOPMENT OF PLANTAR FASCIITIS IN A DIABETIC PATIENT WITH PARTIAL TOE AMPUTATION: A CASE REPORT

Abstract

Background: Plantar fasciitis (PF) is the most common cause of heel pain, often associated with abnormal foot biomechanics. Diabetes mellitus (DM) if uncontrolled lead to complications such as diabetic foot neuropathy and amputation of toe following foot and leg. toe amputation can alter normal foot load distribution. However, plantar fasciitis after partial toe amputation in prolonged diabetic patients is rarely reported.

Case Presentation: We report a case of a 62-years old male with prolonged (14 years history of DM) type 2 diabetes mellitus who developed severe plantar fasciitis (right side) following partial amputation of the second, third and fourth toes of his right foot due to the development of gangrene and infected diabetic ulcers. The patient presented with typical symptoms of plantar fasciitis, including early morning heel pain and tenderness at the medial calcaneal tubercle of the right foot. Clinical assessment based on physical therapy special tests was performed and Windlass test is used for the diagnostic purpose during physical examination, the test with high specificity of 100% and low sensitivity of 32% which confirmed the diagnosis. Conservative management including physiotherapy, custom orthotics, and activity modification resulted in significant symptom relief.

Conclusion: This clinical case report highlights a link between partial toe amputation and the development of unilateral (Amputation side) plantar fasciitis in diabetic individuals. Identifying altered biomechanics in post-amputation feet is crucial for early diagnosis and appropriate conservative intervention.

Keywords: Diabetes mellitus, Toe amputation, Plantar fasciitis, Diabetic foot, Foot biomechanics, Case report