Background. Plantar fasciitis (PF) is a common condition, affecting 10% of adults and accounting for 15% of foot pain consultations. Although 90% of cases resolve within 12 months with conservative treatments, chronic cases require more invasive treatments. Risk factors include a high body mass index and anatomical foot disorders. There is no standard treatment; options range from nonsteroidal anti-inflammatory drugs (NSAIDs) to surgery. Corticosteroids, while effective short term, can cause severe side effects. Platelet-rich plasma (PRP) has shown long-term effectiveness, alleviating pain and improving functionality. Methods. This study, registered in PROSPERO and following PRISMA guidelines, searched for randomized clinical trials in PubMed, Scopus, Cochrane, and Web of Science comparing PRP with corticosteroids from 2019 to April 2024. It focused on patients with PF treated with PRP versus corticosteroids and their improvement in visual analog scale (VAS) pain scores. Randomized clinical trials were included, and the risk of bias was assessed using the Cochrane tool. Visual analog scale pain scores were analyzed using mean differences and a 95% CI. Heterogeneity was assessed with Q and I² tests. A random-effects model was used if significant heterogeneity was present; otherwise, a fixed-effects model was applied. Analysis was conducted with Review Manager 5.4. Results. Thirteen trials met the inclusion criteria, involving 901 subjects (497 with PRP and 404 with corticosteroids). In the short term, there were no significant differences in pain reduction (P = .85). In the medium term, PRP showed better results in VAS pain scores (P < .00001). Conclusion. PRP is a safe and effective alternative for treating PF pain, with better results than corticosteroids in the medium term. Platelet-rich plasma is recommended as the preferred option in the management of chronic PF.

Background: Plantar fat plays a crucial role in protecting and cushioning the metatarsals. Its degeneration is a risk factor for the development of metatarsalgia and, consequently, predislocation syndrome. Objectives: To evaluate the relationship between plantar fat thickness and predislocation syndrome in an adult population, and to determine a possible association between a decrease in forefoot plantar fat and the presence of symptoms. Material and Methods: A retrospective observational study was conducted, including records of patients who visited the podiatry clinic between December 2022 and December 2023. Fifty complete records were selected, divided into two groups, one healthy and one pathological, aged between 18 and 70 years. An ultrasound examination of the plantar area of the second metatarsophalangeal joint was performed to assess the thickness of the fat and plantar plate. Results: The analysis of the 50 records, divided into healthy and pathological groups, reveals significant differences in the thickness of plantar fat and the plantar plate between the two groups. Subjects with predislocation syndrome have a significantly lower plantar fat thickness (0.566 cm) compared to the healthy group (0.941 cm) and also show a greater thickness of the plantar plate (0.359 cm vs. 0.244 cm). Statistical tests confirm these differences with high significance (p < 0.001). The ROC curve shows that plantar fat thickness is a good predictor of predislocation syndrome, with an area under the curve (AUC) of 0.923, emphasizing the utility of this measure in identifying the condition. Conclusions: Preliminary studies suggest that a reduction in plantar fat increases the predisposition to develop predislocation syndrome at the level of the second metatarsophalangeal joint.

Background: Currently, there is no scientific evidence regarding pain in the anesthetic block of the first toe according to the method of application. However, clinical evidence has highlighted the use of the carpule due to the low pain it causes during the administration of the anesthetic. Most studies on anesthesia and pain, especially using the carpule and distraction methods, belong to the field of dentistry. Objective: To compare the pain and effectiveness between the anesthetic block of the first toe using a carpule and syringe with Frost’s H technique and the modified Frost’s H technique. Method: A total of 564 subjects were selected and divided into four groups. Subjects were subjected to experimental conditions (randomization through the Random Allocation Software program 2.0), and divided into group 1 = 138 subjects, corresponding to the block with syringe and Frost’s H, group 2 = 141 subjects, corresponding to the syringe group and modified Frost’s H, group 3 = 141 subjects, corresponding to the carpule group and modified Frost’s H, and group 4 = 144 subjects, corresponding to the carpule group and Frost’s H. The same researcher generated the random allocation sequence, enrolled the participants, and assigned them to the interventions. Each subject was unaware of the anesthetic procedure assigned by the researcher. Outcome parameters were pain after anesthetic infiltration and its effectiveness. Results: The anesthetic block with carpule showed a lower pain score compared to the anesthetic block with syringe (2.8 vs. 5.3; p < 0.001). However, when analyzing effectiveness, a higher efficacy rate was obtained in the anesthetic blocks performed using the modified Frost’s H technique (97.5% vs. 88.1%; p < 0.001). Conclusions: The anesthetic block with carpule and the modified Frost’s H technique is less painful and more effective than the traditional anesthetic block.