摘要
目的探讨关节镜下跖筋膜松解联合跟骨骨刺清除术治疗顽固性跟痛症的临床疗效。方法回顾性分析中山市中医院创伤骨科足踝组2018年4月至2022年6月期间,关节镜下采用跖筋膜松解联合跟骨骨刺清除术治疗顽固性跟痛症的患者30例,其中男8例,女22例;年龄43~69岁,平均(54.7±7.9)岁,定期于门诊复诊并完成随访。观察并记录术后相关并发症发生情况并定期复查术侧跟骨侧位X线片判断术侧跟骨骨刺是否复发。通过对比术前、术后1个月、术后3个月及末次随访时患者疼痛视觉模拟评分(visual analogue scale,VAS)、美国足踝外科协会踝-后足(American orthopedic foot and ankle society ankle and hindfoot,AOFAS-AH)评分和跟痛症评分(calcaneodynia score,CS)来评价手术疗效。结论30例患者术后随访时间为12~20个月,平均(16.27±2.32)个月。30例患者术后各观察时间点的VAS评分均低于术前,而AOFAS-AH评分和CS评分均高于术前,手术前后对比差异均有统计学意义(P<0.001)。术后定期复查术侧跟骨侧位X线片示跟骨骨刺均无复发。无一例患者出现血管、神经损伤、术口感染等并发症。结论关节镜下跖筋膜松解联合跟骨骨刺清除术能够显著缓解顽固性跟痛症患者足跟局部疼痛,改善足踝功能,其疗效满意,是一种值得推广的治疗方式。
Objective To explore the clinical efficacy of arthroscopic plantar fascia release combined with calcaneal spur removal surgery in the treatment of intractable calcaneodynia.Methods A retrospective analysis was conducted on 30 patients with recalcitrant calcaneodynia who underwent arthroscopic plantar fascia release combined with calcaneal spur clearance surgery in the Foot and Ankle Group of the Trauma Orthopedics Department of Zhongshan Hospital of Traditional Chinese Medicine from April 2018 to June 2022.They were 8 males and 22 females,with ages ranging from 43 to 69 years old and a mean age of(54.7±7.9)years,Regular follow-up visits were conducted at the outpatient department.We observed and recorded the occurrence of postoperative complications,and regularly reviewed the lateral calcaneal X-rays film on the surgical side to determine whether the calcaneal spur recurred.The surgical efficacy was also evaluated by comparing the patients'pain visual analogue scale(VAS)scores,American orthopedic foot and ankle society ankle and hindfoot(AOFAS-AH)scores,and calcaneodynia scores(CS)at the preoperative period,1 month after surgery,3 months after surgery,and the last follow-up.Results The postoperative follow-up time was 12~20 months,with an average of(16.27±2.32)months.The VAS scores of the 30 patients were lower than the preoperative scores at all observation time points postoperative period,while the AOFAS-AH scores and CS were higher than the preoperative scores,and the differences between the preoperative and postoperative period comparisons were statistically significant(P<0.001).Regular postoperative follow-up of lateral calcaneal X-rays film on the surgical side showed no recurrence of calcaneal spur.None of the patients had complications such as vascular or nerve injury or infection of the operative port.Conclusion Arthroscopic plantar fascia release combined with calcaneal spur removal surgery can significantly relieve localized pain and improve foot and ankle function in patients with intractable calcan
作者
邓斌
郑臣校
吴健波
张绍海
林小永
Deng Bin;Zheng Chenxiao;Wu Jianbo;Zhang Shaohai;Lin Xiaoyong(Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine,Zhongshan 528400,China)
出处
《实用骨科杂志》
2024年第2期133-137,共5页
Journal of Practical Orthopaedics
基金
广东省基础与应用基础研究基金企业联合基金重点项目(2022B1515230008)
中山市医学科研基金项目(2020A020298)。
关键词
顽固性跟痛症
跖筋膜
跟骨骨刺
关节镜
intractable calcaneodynia
plantar fascia
calcaneal spur
arthroscopy
