实时B超引导下经皮跖腱膜切断术治疗顽固性跖腱膜炎(附472例报道)  被引量:7

Treatment of recurrent plantar fasciitis with percutaneous plantar fasciotomy guided by real-time B-ultrasound-a report of 472 cases

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作  者:程迅生[1] 章仁品[2] 罗福成[2] 吴端[1] 赵克义[1] 

机构地区:[1]解放军第105医院骨科,合肥230031 [2]解放军第105医院特诊科,合肥230031

出  处:《中国矫形外科杂志》2009年第5期344-347,共4页Orthopedic Journal of China

摘  要:[目的]探讨实时B超引导下经皮跖腱膜切断术治疗顽固性跖腱膜炎的临床疗效。[方法]从1997年6月~2007年5月共对472例顽固性跖腱膜炎患者共611足行实时B超引导下经皮跖腱膜切断术。472例患者中男177例,女295例;年龄20~71岁(平均53.4岁);体态肥胖者176例、正常者279例、瘦弱者17例。单足发病者285例、双足发病者187例,病程6个月~20年(中位数12个月)。对病程大于6个月、VAS(Visual Analog Scale)值≥6、B超检查提示有跖腱膜跟骨附着部明显增厚等跖腱膜炎表现的611足行手术治疗。术前VAS值为6~10分(平均8.4分)。术后有376例患者获得长期随防,随防时间为6~36个月(平均18.4个月)。[结果]术后VAS值为0者有349例(占92.8%);VAS值为1~2者有27例(7.2%)。术后达最佳疗效所需要的时间为7 d^6个月,其中术后达最佳疗效所需要的时间为7~14 d者有302例(80.3%),为2~3个月者有56例(14.9%),为4~6个月者有18例(4.8%)。所有病人均无足底内、外侧血管、神经损伤;均无切口感染;无明显切口瘢痕形成。[结论]实时B超引导下经皮跖腱膜切断术是治疗顽固性跖腱膜炎较为简便、安全有效的手术方法。[ Objective] To evaluate the effects of percutaneous plantar fasciotomy guided by realtime B -ultrasound in the treatment of recurrent plantar fasciitis. [Method] From June 1997 to May 2007, 611 feet of 472 patients suffering from recurrent plantar fasciitis were treated with percutaneous plantar fasciotomy guided by real - time B - ultrasound. All the patients were aged from 20 - 71 years ( mean 53.4 years) with the duration of disease from 6 months to 20 years ( median 12 months) . There were 177 males and 295 females. One foot was involved in 285 and two feet in 187 patients. A total of 611 feet, with the illness duration more than 6 months and VAS ( Visual Analog Scale) ≥ 6 and having B - ultrasound manisfestations such as thickening of plantar fascia on calcaneum, were underwent percutaneous plantar fasciotomy guided by real - time B - ultrasound. Before operation VAS was 6 to 10 ( mean 8.4) . Totally 376 patients were followed from 6 to 36 months ( mean 18.4 months) . [ Result] Postoperative VAS was 0 in 349 (92. 8% ), 1 -2 in 27 patients (7. 2% ) . The time needed to achieve best postopetative effect was 7 days to 6 months. Of all the patients, 302 (80. 3% ) achieved the best effect within 7 to 14 days, 56 ( 14. 9% ) within 2 to 3 months and 18 (4.8%) within 4-6 months. No patients were found to have complicated incision infection or injuries to medial or lateral plantar vessels and nerves. Incision scar was not obvious in all cases. [ Conclusion] It can be concluded that percutaneous plantar fasciotomy guided by real - time B - ultrasound is a simple, safe and effective operative procedure in the treatment of recurrent plantar fasciitis.

关 键 词:跖腱膜炎 经皮跖腱膜切断术 实时B超引导 

分 类 号:R687.4[医药卫生—骨科学]

 

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