内侧双通道关节镜下跖筋膜松解结合骨刺去除治疗顽固性跟痛症20例  

20 Cases Treatment of Intractable Heel Pain by Medial Two-Channel Arthroscopic Plantar Fascia Release Combined with Bone Spur Removal

作　　者：杨威 吴美平 李光富 华贤章 YANG Wei;WU Meiping;LI Guangfu;HUA Xianzhang(Enshi Prefecture Ethnic Hospital,Enshi 445000,Hubei China)

机构地区：[1]湖北恩施州民族医院骨伤科,湖北恩施445000

出　　处：《中国中医骨伤科杂志》2023年第1期69-72,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨内侧双通道关节镜下跖筋膜松解结合骨刺去除治疗顽固性跟痛症(PHS)的临床疗效。方法:选取2020年1月至2021年12月收治的顽固性跟痛症患者20例。年龄为40~75岁,平均年龄为(56.80±8.93)岁;女14例,男6例;病程为3~35个月,平均为(16.35±9.45)个月;右足16例,左足4例。采取内侧双通道关节镜下跖筋膜松解结合骨刺去除手术方式,术后复查患侧跟骨侧位X线片评估跟骨骨刺手术去除情况。以患者手术前及术后第3个月疼痛视觉模拟量表(VAS)评分和美国足踝外科协会踝与后足(AOFAS-AH)评分评估疼痛缓解及手术后功能恢复情况。结果:20例患者每例手术平均耗时(48.50±8.92)min,伤口均I/甲级愈合,无感染病例,术后复查X线片见跟骨增生骨刺消失。所有病例均获得随访,随访时间为(4.55±1.10)个月。手术前疼痛评分为(7.60±0.68)分,术后3个月时疼痛明显减轻,评分为(2.70±0.73)分,差异有统计学意义(t=30.051,P<0.001)。术前AOFAS-AH评分为(35.00±6.07)分,术后明显升高,评分为(81.50±5.16)分,差异有统计学意义(t=28.593,P<0.001)。结论:内侧双通道关节镜下跖筋膜松解结合骨刺去除治疗顽固性跟痛症可微创下同时缓解跟骨骨刺、跟骨高压、跖筋膜炎情况,明显减轻足跟疼痛,促进足踝功能恢复,且手术安全系数较高,值得临床推广应用。Objective:To explore the clinical efficacy of medial two-channel arthroscopic plantar fascia release combined with bone spur removal on the treatment of intractable heel pain.Methods:Twenty patients with obstinate painful heel syndrome(PHS),aged from 40 to 75 years old, with average age of(56.80±8.93) years old, were selected from January 2020 to December 2021.There were 14 females and 6 males.The course of disease ranged from 3 to 35 months, with average of(16.35±9.45) months.There were 16 cases of right foot and 4 cases of left foot.The medial two-channel arthroscopic plantar fascia release combined with bone spur removal was adopted.After operation, the calcaneal lateral axial X-ray of the affected side was reexamined to evaluate the removal of calcaneal bone spur.The pain relief and postoperative functional recovery were evaluated by the pain score(VAS) before operation and 3 months after operation and the American Association of Foot and Ankle Surgery Ankle and Hindfoot(AOFAS-AH) score.Results:The average operation time of 20 patients was(48.50±8.92) min, all patients were healed at the first grade without infection.The postoperative X-ray showed that calcaneal hyperplasia and bone spur disappeared.All cases were followed up for(4.55±1.10) months.The preoperative pain score was 7.60±0.68,and the pain decreased significantly 3 months after operation, with a score of 2.70±0.73.The difference was statistically significant(t=30.051,P<0.001).The preoperative AOFAS-AH score was 35.00±6.07,and increased significantly after operation with score of 81.50±5.16,and the difference was statistically significant(t=28.593,P<0.001).Conclusion:Medial two-channel arthroscopic plantar fascia release combined with bone spur removal on the treatment of intractable calcaneal pain can minimally relieve calcaneal bone spur, calcaneal hypertension and plantar fasciitis at the same time, significantly reduce heel pain and promote the recovery of foot and ankle function.Futhermore, the operation safety factor is high, which is

关 键 词：关节镜 跟痛 骨刺 跖筋膜 

分 类 号：R628.6[医药卫生—整形外科]