Baxter D E, Pfeffer G B
Baylor College of Medicine, Department of Orthopaedics, Houston, Texas.
Clin Orthop Relat Res. 1992 Jun(279):229-36.
Sixty-nine heels (53 patients) with chronic heel pain had a surgical release of the first branch of the lateral plantar nerve. The average duration of heel-pain symptoms was 23 months (range, six months to eight years). No patient had less than six months of conservative treatment before surgery. The average duration of preoperative conservative treatment was 14 months. Forty-four patients (83%) had taken nonsteroidal antiinflammatory agents. Sixty-three heels (91%) had used heel cups and/or orthoses. Fifty-nine heels (86%) had received one or more injections of a steroid preparation. Thirty-four heels had developed pain initially during a sports activity. Postoperatively, 61 heels (89%) had excellent or good results; 57 heels (83%) had complete resolution of pain. The average follow-up period was 49 months. In general, heel pain resolves with conservative treatment. In recalcitrant cases, however, entrapment of the first branch lateral plantar nerve should be suspected. Surgical release of this nerve can be expected to provide excellent relief of pain and facilitate return to normal activity.
69例（53名患者）患有慢性足跟痛的足跟接受了足底外侧神经第一分支的松解手术。足跟痛症状的平均持续时间为23个月（范围为6个月至8年）。术前没有患者接受过少于6个月的保守治疗。术前保守治疗的平均持续时间为14个月。44例患者（83%）服用过非甾体类抗炎药。63只足跟（91%）使用过足跟垫和/或矫形器。59只足跟（86%）接受过一次或多次类固醇制剂注射。34只足跟最初在体育活动期间出现疼痛。术后，61只足跟（89%）获得了优或良的结果；57只足跟（83%）疼痛完全缓解。平均随访期为49个月。一般来说，足跟痛可通过保守治疗缓解。然而，在顽固性病例中，应怀疑足底外侧神经第一分支受压。预计该神经的松解手术可显著缓解疼痛并促进恢复正常活动。
