内镜下足底筋膜松解术治疗慢性足底筋膜炎的疗效和安全性

Hesham Ali
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引用次数: 0

摘要

本研究旨在评价内镜下足底筋膜松解术(EPFR)治疗慢性足底筋膜炎的疗效及其安全性。患者与方法2015年3月至2018年6月,30例慢性足底筋膜炎患者参与了本研究。17例女性,13例男性,平均年龄46岁(35 ~ 52岁)。所有患者均有保守治疗失败史。采用内窥镜下足底筋膜松解术治疗。如果存在足跟骨刺,则用关节镜下的毛刺切除。采用美国骨科足踝社会量表(AOFAS)和Roles and Maudsley评分对疼痛和功能限制进行评估。结果随访结束时,AOFAS平均分由术前67分上升至93分,差异有统计学意义(P <0.0001),具有临床意义。结果优16例(53.3%),良8例(26.6%),尚可4例(13.33%),差2例(6.66%)。3例术后出现门静脉内侧浅表感染。2例出现足底麻木和感觉异常。三名患者持续出现启动疼痛,但在两个月内消退。术后至完全体重的平均持续时间为40天。所有患者平均10周后恢复完全活动。结论内镜是治疗耐药病例的最佳方法,但也存在并发症。EPFR应仅用于经过一段保守治疗试验期后的重症病例。
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The results and safety of endoscopic plantar fascia release for treatment of chronic plantar fasciitis

Background

A prospective study was conducted to evaluate the results of endoscopic plantar fascia release (EPFR) and its safety in treating patients with chronic plantar fasciitis.

Patients and methods

Thirty patients who had chronic plantar fasciitis for more than 6 months participated in this study from March 2015 to June 2018. Seventeen patients were females, and thirteen were males with an average age of 46 years (ranged between 35 and 52 years). All patients had a failed history of conservative treatment. They were treated with endoscopic plantar fascia release. If a heel spur existed, it was resected by an arthroscopic burr. Pain and functional limitations were evaluated with the American Orthopedic Foot and Ankle Society Scale (AOFAS) and Roles and Maudsley score.

Results

At the end of follow-up, the mean AOFAS scoring changed significantly from 67 points before surgery to 93 points (P < .0001) which was clinically significant. Sixteen (53.3%) patients had excellent results, 8 (26.6%) patients had good results, 4 (13.33%) patients had acceptable results, and 2 (6.66%) patients had poor results. Three cases complained of postoperative superficial infection at the medial portal. Two cases developed numbness and paraesthesia at the sole of the foot. Three patients had ongoing start-up pain that resolved within two months. The mean duration to full weight bearing after surgery was 40 days. All patients returned to full activities by a mean of 10 weeks.

Conclusion

Endoscopy offers the optimum solution for the resistant cases, but is not without complications. EPFR should be reserved only for severe cases after a trial period of conservative methods of treatment.

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来源期刊
Journal of Arthroscopy and Joint Surgery
Journal of Arthroscopy and Joint Surgery Medicine-Orthopedics and Sports Medicine
CiteScore
0.60
自引率
0.00%
发文量
1
期刊介绍: Journal of Arthroscopy and Joint Surgery (JAJS) is committed to bring forth scientific manuscripts in the form of original research articles, current concept reviews, meta-analyses, case reports and letters to the editor. The focus of the Journal is to present wide-ranging, multi-disciplinary perspectives on the problems of the joints that are amenable with Arthroscopy and Arthroplasty. Though Arthroscopy and Arthroplasty entail surgical procedures, the Journal shall not restrict itself to these purely surgical procedures and will also encompass pharmacological, rehabilitative and physical measures that can prevent or postpone the execution of a surgical procedure. The Journal will also publish scientific research related to tissues other than joints that would ultimately have an effect on the joint function.
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