内镜下部分跖筋膜切除术治疗足底跖筋膜纤维瘤的初步疗效  

Preliminary Study on the Effect of Endoscopic Partial Plantar Fascia Resection in the Treatment of Plantar Fibroma

作　　者：王颖[1] 秦建忠[2] 宋小妹[1] 李伟[3] Wang Ying;Qin Jianzhong;Song Xiaomei;Li Wei(Department of Wound Center,The Second Afiliated Hospital of Soochow University,Suzhou 215004,China;Department of Hand and Foot Surgery,The Second Afiliated Hospital of Soochow University,Suzhou 215004,China;Soochow University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院伤口中心,苏州215004 [2]苏州大学附属第二医院手足外科,苏州215004 [3]苏州大学,苏州215004

出　　处：《中国运动医学杂志》2023年第3期178-183,共6页Chinese Journal of Sports Medicine

基　　金：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);苏州大学2021年“大学生创新创业训练计划项目”(2021SUDA045)。

摘　　要：目的:探讨内镜下部分跖筋膜切除术治疗足底跖筋膜纤维瘤的初步临床疗效。方法:回顾性分析我科2020年1月~2022年1月收治的8例足底跖筋膜纤维瘤患者,其中男5例、女3例,年龄36~52岁,平均42.1岁。均为单侧,左侧6例、右侧2例。所有患者手术均在仰卧位下进行,术中在足内侧红白交界线上、跖筋膜纤维瘤两侧分别建立操作通道和观察通道。内镜下在跖筋膜纤维瘤周围清理并造腔后显露病灶,直视下行包含纤维瘤在内的扩大、部分跖筋膜切除术。手术前及末次随访时应用疼痛视觉模拟评分(VAS)、美国足踝外科协会踝-后足(AOFAS-AH)评分,以及SF-36健康调查简表评分进行疗效评估。结果:术后所有患者切口均获得一期愈合,局部疼痛症状均显著改善。术后随访时间10~22个月(平均17.5个月)。VAS评分由术前的6.3±1.0分下降到末次随访时的1.8±0.8分,AOFAS-AH评分由术前的45.5±6.3分提高到末次随访时的86.1±3.5分,SF-36健康调查简表评分由术前的51.3±4.8分改善到末次随访时的83.5±5.0分。术前与末次随访时评分比较差异有统计学意义(P<0.01)。至末次随访时所有患者未见跖筋膜纤维瘤复发。结论:内镜下部分跖筋膜切除术治疗创伤小、恢复快、并发症少,治疗足底跖筋膜纤维瘤的短期疗效优良。Objective To explore the preliminary effect of endoscopic partial plantar fasciectomy in the treatment of plantar fibroma.Methods Eight patients(5 males and 3 females)with plantar fibroma and treated in our department between January 2020 and January 2022 were analyzed respectively.They ranged in age from 36 to 52,with an average age of 42.1 years.All patients were affected unilaterally,with 6 on the left side and 2 on the right.They underwent the operation in the supine position.During the surgery,the operation and observation channels were respectively established on the red-white junction line of the medial foot and on the proximal and distal side of the plantar fibroma.The lesions were exposed after endoscopic cleaning and cavity building around the plantar fascia fibroma,before the extended and partial plantar fasciectomy including fibroma was performed.Before the surgery and at the last fllow-up,all patients were evaluated using the visual analogue scale(VAS),the American Society for Foot and Ankle Surgery's Ankle-posterior Foot(AOFAS-AH),and the SF-36 Health Survey Brief Form.Results The primary healing was achieved among all patients,and their local painsweresignificantly relieved.Thee average postoperative follow-upperiod was 17.5 months,ranging from 10 to 22 months.The averageVAS,AOFAS-AH and SF-36 health survey short form score improved significantly from preoperative 6.3±1.0,45.5±6.3 and 51.3±4.8 to 1.8±0.8,86.1±3.5 and 83.5±5.0 at the final follow-up,respectively.Norecurrence of plantar fibroma was found in the follow-up.Conclusion Endoscopic partial fasciectomy for plantar fibroma has the advantages of less trauma,faster recovery and fewer complications,showinggan excellent short-term curative effect.

关 键 词：跖筋膜 纤维瘤 内镜 

分 类 号：R658.3[医药卫生—外科学]