摘要目的 研究单侧双通道关节镜下微创手术治疗慢性足底筋膜炎的临床效果。方法 回顾性分析2019年5月至2020年4月上海市第十人民医院骨科采用关节镜治疗的28例慢性足底筋膜炎患者资料,其中男13例,女15例;年龄45~73岁,平均(58.14±8.75)岁。患者经至少6个月的保守治疗无效后,均行单侧双通道关节镜手术,手术方式包括足底筋膜部分松解及跟骨骨刺磨除。通过比较手术前后疼痛视觉模拟评分(visual analogue scale,VAS)、美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝与后足评分及健康调查简表(the MOS item short from health survey, SF-36)评价效果。结果 患者术后均获12个月随访。患者均创口Ⅰ期愈合,未出现血管、神经及肌腱损伤等并发症。术后12个月,患者足底疼痛症状基本消失,足底骨刺和疼痛无复发,踝关节及足部运动接近正常;足跟部VAS由术前(5.75±1.24)分降至(0.39±1.10分),AOFAS评分由术前(53.96±15.71)分升至(97.79±5.17)分,SF-36评分由术前(86.21±8.58)分升至(136.25±8.67)分,手术前后比较差异均有统计学意义(P<0.01);足内弓角由术前(117.05±3.50) °降为(116.93±3.37) °,足弓无明显塌陷(P=0.44)。结论 经单侧双通道入路全关节镜下足底筋膜松解术治疗慢性足底筋膜炎效果满意,关节镜微创手术是可供选择的有效方法。
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