Abstract:Objective To explore the clinical efficacy of arthroscopic plantar fascia release combined with calcaneal spur removal surgery in the treatment of intractable calcaneodynia. Methods A retrospective analysis was conducted on 30 patients with recalcitrant calcaneodynia who underwent arthroscopic plantar fascia release combined with calcaneal spur clearance surgery in the Foot and Ankle Group of the Trauma Orthopedics Department of Zhongshan Hospital of Traditional Chinese Medicine from April 2018 to June 2022.They were 8 males and 22 females,with ages ranging from 43 to 69 years old and a mean age of (54.7±7.9) years,Regular follow-up visits were conducted at the outpatient department.We observed and recorded the occurrence of postoperative complications,and regularly reviewed the lateral calcaneal X-rays film on the surgical side to determine whether the calcaneal spur recurred.The surgical efficacy was also evaluated by comparing the patients’ pain visual analogue scale (VAS) scores,American orthopedic foot and ankle society ankle and hindfoot (AOFAS-AH) scores,and calcaneodynia scores (CS) at the preoperative period,1 month after surgery,3 months after surgery,and the last follow-up. Results The postoperative follow-up time was 12~20 months,with an average of (16.27±2.32) months.The VAS scores of the 30 patients were lower than the preoperative scores at all observation time points postoperative period,while the AOFAS-AH scores and CS were higher than the preoperative scores,and the differences between the preoperative and postoperative period comparisons were statistically significant ( P <0.001).Regular postoperative follow-up of lateral calcaneal X-rays film on the surgical side showed no recurrence of calcaneal spur.None of the patients had complications such as vascular or nerve injury or infection of the operative port. Conclusion Arthroscopic plantar fascia release combined with calcaneal spur removal surgery can significantly relieve localized pain and improve foot and ankle function in patients with intractable calcaneodynia.The therapeutic effect is satisfactory and it is a treatment method worth promoting.
邓斌,郑臣校,吴健波,张绍海,林小永. 关节镜下跖筋膜松解联合跟骨骨刺清除术治疗顽固性跟痛症[J]. 实用骨科杂志, 2024, 30(2): 133-.
Deng Bin,Zheng Chenxiao,Wu Jianbo,Zhang Shaohai,Lin Xiaoyong. Arthroscopic Plantar Fascia Release Combined with Calcaneal Spur Removal Surgery in the Treatment of Intractable Calcaneodynia. sygkzz, 2024, 30(2): 133-.
[1] 吴石奇,沈忠杰.关节镜下微创手术治疗顽固性跟痛症的临床疗效[J].广西医学,2019,41(17):2246-2248.
[2] Moroney PJ,O’Neill BJ,Khan-Bhambro K, et al .The conundrum of calcaneal spurs:Do they matter?[J].Foot Ankle Spec,2014,7(2):95-101.
[3] Schneider HP,Baca JM,Carpenter BB, et al .American college of foot and ankle surgeons clinical consensus statement:Diagnosis and treatment of adult acquired infracalcaneal heel pain[J].J Foot Ankle Surg,2018,57(2):370-381.
[4] Cottom JM,Baker JS.Endoscopic plantar fascia debridement for chronic plantar fasciitis[J].Clin Podiatr Med Surg,2016,33(4):545-551.
[5] 孙建民,孙良智,苏保辉,等.微创治疗老年跟骨结节骨赘型跟痛症临床疗效分析[J].中国矫形外科杂志,2012,20(17):1572-1575.
[6] 高锋,殷浩荣,陈广辉,等.关节镜下跖腱膜松解联合跟腱止点清理术治疗顽固性跟痛症[J].实用骨科杂志,2023,29(05):465-467.
[7] 李忠,姜厚森,刘俊华,等.顽固性跟痛症的手术治疗[J].中国矫形外科杂志,2018,26(10):918-922.
[8] 陈杲,杨国平,唐玲,等.透视定位双内侧入路关节镜下跖腱膜松解和骨质增生清除术治疗顽固性跟痛症的疗效分析[J].基层医学论坛,2021,25(26):3729-3731.
[9] 罗富强,谢康麒,李载永,等.慢性顽固性跟痛症的病因和治疗新进展[J].广东医学,2022,43(12):1573-1580.
[10] Ahmad J,Karim A,Daniel JN.Relationship and classification of plantar heel spurs in patients with plantar fasciitis[J].Foot Ankle Int,2016,37(9):994-1000.
[11] Menz HB,Thomas MJ,Marshall M, et al .Coexistence of plantar calcaneal spurs and plantar fascial thickening in individuals with plantar heel pain[J].Rheumatology (Oxford),2019,58(2):237-245.
[12] 周游,杨明宇,陶旭,等.跟痛症发病机制新见解与治疗策略[J].中国运动医学杂志,2017,36(9):829-833.
[13] 王炯,吴永光.钻孔减压结合镜下磨削术治疗跟痛症29例[J].中国中医骨伤科杂志,2021,29(2):64-66.
[14] Feng SM,Wang AG,Sun QQ, et al .Functional results of all-inside arthroscopic brostrom-gould surgery with 2 anchors versus single anchor[J].Foot Ankle Int,2020,41(6):721-727.
[15] 孙官军,叶永杰,银毅,等.关节镜手术在顽固性跟痛症治疗中的应用[J].中华解剖与临床杂志,2018,23(3):245-250.
[16] 冯仕明,王爱国,常步青,等.内侧双通道全关节镜技术治疗顽固性足底筋膜炎的效果分析[J].中华外科杂志,2019,57(11):829-833.
[17] Thomas ZM,Thomas KJ.Technique tip:Singleincision endoscopic plantar fasciotomy[J].Foot Ankle Spec,2017,10(3):240241.
[18] Nery C,Raduan F,Mansur N, et al .Endoscopic approach for plantar fasciopathy:A long-term retrospective study[J].J Int Orthop,2013,37(6):1151-1156.
[19] Al-Ashhab ME,Elbegawy H,Hasan H.Endoscopic plantar fasciotomy through two medial portals for the treatment of recalcitrant plantar fasciopathy[J].J Foot Ankle Surg,2018,57(2):264-268.
[20] 冯仕明,马超,陈杰,等.全内侧深入路造腔内镜技术在难治性跖筋膜炎治疗中的应用[J].中华解剖与临床杂志,2022,27(4):226-231.
[21] Miyamoto W,Yasui Y,Miki S, et al .Endoscopic plantar fascia release via a suprafascial approach is effective for intractable plantar fasciitis[J].Knee Surg Sports Traumatol Arthrosc,2018,26(10):3124-3128.
[22] Johannsen F,Konradsen L,Herzog R, et al .Endoscopic fasciotomy for plantar fasciitis provides superior results when compared to a controlled non-operative treatment protocol:A randomized controlled trial[J].Knee Surg Sports Traumatol Arthrosc,2020,28(10):3301-3308.
[23] 黄鲁丰,贺华勇,李杰华,等.跟痛症患者跟骨内侧突骨刺的解剖学研究[J].中医正骨,2021,33(4):51-54.