足底部分筋膜切除术治疗足底纤维瘤病

Lucas Plens de Britto Costa, L. Fonseca, A. Lemos, V. Pereira, C. C. César Netto, F. Raduan, C. Nery, N. Mansur
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摘要

目的:我们描述了一系列患者的治疗与切除患带。我们评估了功能结果、复发率和手术伤口并发症,并将这些数据与现有文献进行了比较。方法:本回顾性研究(证据级别IV)包括14例(17英尺)诊断为筋膜内侧足底纤维瘤病,保守治疗难治的患者。所有手术均在2016年12月至2018年11月期间进行。评估所有患者的症状改善、主要和次要并发症以及研究期间的复发情况。结果:本组样本男9名,女5名,平均年龄40.6岁(15-63岁)。所有患者均行内侧筋膜带部分切除,边缘至少为2厘米。17个足部中有5个复发(29%),但只有2个需要进一步干预。3例(17%)患者出现伤口裂开,其中1例严重,需要整形手术。两只脚上有足底内侧神经指支受伤的痕迹。结论:部分足底筋膜切除术是足底纤维瘤病的一种替代治疗方法。我们的结果在复发和术后并发症方面与文献一致。在指示该手术时,必须考虑到并发症的中等发生率。证据水平IV;治疗研究;病例系列。
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Partial plantar fasciectomy for the treatment of plantar fibromatosis
Objective: We describe a series of patients treated with resection of the affected band. We assessed functional outcome, recurrence  rate, and surgical wound complications, comparing these data with the available literature. Methods: This retrospective study (level of evidence IV) included 14 patients (17 feet) diagnosed with plantar fibromatosis in the medial portion of the fascia that was refractory to conservative treatment. All operations were performed between December 2016 and November 2018. All patients were assessed for symptom improvement and major and minor complications, in addition to recurrence during the study period.Results: Our sample included 9 men and 5 women, whose mean age was 40.6 years (15-63). All of the patients underwent partial fasciectomy of the medial fascial band with margins of at least 2 cm. There was recurrence in 5 of the 17 feet (29%), but only two required further intervention. Wound dehiscence occurred in 3 patients (17%), and one of the cases was severe, requiring plastic surgery. Two feet showed signs of injury to the digital branch of the medial plantar nerve. Conclusion: Partial plantar fasciectomy is an alternative treatment for plantar fibromatosis (Ledderhose’s disease). Our results agree with the literature in terms of recurrence and postoperative complications. The moderate rate of complications must be taken into account when indicating this procedure. Level of Evidence IV; Therapeutic Studies; Case Series.
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