目的:足底和足跟痛最常见的原因是足底筋膜炎和跟骨刺,它们经常共存。手术是难治性足底筋膜炎的公认治疗方法。然而,很少有研究提出了骨刺的meta趾筋膜炎患者的治疗选择。因此,这项研究的目的是提出一个四步手术方案,改善骨赘足底筋膜炎的手术效果,建立手术治疗方法。
方法:回顾性分析了2020年至2023年45例患有骨刺的足底筋膜炎患者。所有患者都接受了四步手术,包括足底筋膜松解术,跟骨骨刺磨削,炎性组织切除,跟骨毛刺减压.记录手术前后的影像学参数和功能评分。客观评价包括在X光片上测量跟骨骨刺长度。临床评估包括美国骨科足踝协会(AOFAS),视觉模拟刻度(VAS),和足踝结果量表(FAOS)。符合正态分布的测量数据表示为(x2±s),以及AOFAS术前和术后,FAOS,和VAS评分使用重复测量方差分析进行比较,术前和术后的骨刺长度使用配对t检验进行比较。
结果:45例患者随访3~30个月,(17.72±8.53)个月,在最后的后续行动中,患者的AOFAS评分从术前(74.93±5.56)提高到(94.78±3.98),FAOS评分由术前(76.42±3.37)分提高至(96.16±2.74)分,VAS评分从(3.18±0.54)降至(1.07±1.20)(p<0.05),骨刺长度由(0.72±1.81)cm降至(0.23±1.19)cm,手术前后差异有统计学意义(p<0.05)。
结论:四步手术方案是治疗骨刺足底筋膜炎的合适且有效的手术方法。
OBJECTIVE: The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co-exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this
study\'s purpose was to propose a four-step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment.
METHODS: Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four-step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre-and postoperative AOFAS, FAOS, and VAS scores were compared using repeated-measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t-tests.
RESULTS: The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow-up, the patient\'s AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p < 0.05), the length of spur decreased from (0.72 ± 1.81) cm to (0.23 ± 1.19) cm, and there were significant differences before and after operation (p < 0.05).
CONCLUSIONS: The four-step surgical regimen is an appropriate and effective surgical procedure to treat plantar fasciitis with bone spurs.