经皮微创跖筋膜松解联合跟骨减压治疗跖筋膜炎12例  

Percutaneous Minimally Invasive Plantar Fascia Release Combined With Calcaneal Decompression for the Treatment of 12 Cases of Refractory Plantar Fasciitis

作　　者：李伟[1] 秦建忠[2] 周聚普[2] 张勇[2] 蒋涛 张勇 Li Wei;Qin Jianzhong;Zhou Jupu(不详;Department of Hand and Foot Surgery,Second Affiliated Hospital of Soochow University,Suzhou 215004,China)

机构地区：[1]苏州大学,苏州215004 [2]苏州大学附属第二医院手足外科,苏州215004

出　　处：《中国微创外科杂志》2022年第5期431-435,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：苏州大学2021年“大学生创新创业训练计划项目”(2021SUDA045);苏州大学放射医学与辐射防护国家重点实验室开放课题(GZK1202113);苏州大学附属第二医院核技术医学应用重点人才项目(XKTJ-HRC2021005);四川大学生物治疗国家重点实验室开放研究课题项目(SKLB202012)。

摘　　要：目的探讨经皮微创跖筋膜松解联合跟骨减压治疗保守治疗无效的跖筋膜炎的临床疗效。方法2018年1月~2019年12月对12例保守治疗无效的跖筋膜炎足跟内侧经皮做一小切口,微创下行跖筋膜松解,切断跖筋膜内侧1/2,同时在足跟压痛点处以2.0 mm克氏针垂直跟骨骨面钻孔,进行局部减压。术前后采用疼痛视觉模拟评分(Visual Analogue Scale,VAS)、美国足踝外科协会踝-后足(American Orthopaedic of Foot and Ankle Surgery Ankle-Hindfoot,AOFAS-AH)评分及足与踝预后量表(Foot and Ankle Outcome Scale,FAOS)进行评估。结果术后切口均一期愈合,均未发生血管神经损伤、感染等并发症。12例术后随访6~12个月,(9.2±1.7)月。VAS评分由术前(7.9±0.3)分,改善为末次随访时(1.5±0.2)分(P=0.000)。AOFAS-AH评分由术前(48.9±1.2)分,提高到末次随访时(82.5±0.7)分(P=0.000)。FAOS评分由术前(42.2±0.8)分,提高到末次随访(82.6±1.1)分(P=0.000)。结论经皮微创跖筋膜松解联合跟骨减压术可有效缓解保守治疗无效的跖筋膜炎症状,创伤小,恢复快。Objective To investigate the clinical effect of percutaneous minimally invasive plantar fascia release combined with calcaneal decompression in the treatment of refractory plantar fasciitis.Methods Twelve cases of refractory plantar fasciitis admitted to our hospital from January 2018 to December 2019 were reviewed.A small incision was made on the inner side of the heel to release the plantar fascia,and the inner 1/2 of the plantar fascia was cut off.At the same time,a 2.0 mm Kirschner wire was drilled perpendicular to the calcaneal surface at the point of heel tenderness as a local decompression.The pain visual analog uescale(VAS),the American Orthepaedic of Foot and Ankle Surgeon Ankle-Hindfoot(AOFAS-AH)Score and the Foot and Ankle Outcome Scale(FAOS)were used for preoperative and postoperative follow-up assessments.Results All the incisions were healed primarily after operation,and there were no complications such as vascular and nerve injury or infection.Postoperative follow-ups lasted for 6-12 months,with an average of(9.2±1.7)months.The VAS score was improved from(7.9±0.3)points before operation to(1.5±0.2)points at last follow-up(P=0.000).The AOFAS-AH score was improved from(48.9±1.2)points before operation to(82.5±0.7)points at last follow-up(P=0.000).The FAOS score was improved from(42.2±2.8)points before operation to(82.6±1.1)points at last follow-up(P=0.000).Conclusion Percutaneous minimally invasive plantar fascia release combined with calcaneal decompression can effectively relieve the symptoms of refractory plantar fasciitis,with less trauma and quicker recovery.

关 键 词：跟痛症 跖筋膜炎 减压 

分 类 号：R68[医药卫生—骨科学]