Vohra Praveen K, Japour Christopher J
Department of Surgery, Northport Veterans Affairs Medical Center, 79 Middleville Rd, Northport, NY 11738, USA.
J Am Podiatr Med Assoc. 2009 May-Jun;99(3):183-90. doi: 10.7547/0980183.
Ultrasound-guided plantar fascia release offers the surgeon clear visualization of anatomy at the surgical site. This technique uses small arthroscopic dissecting instruments through a 0.5-cm incision, allowing the surgeon to avoid the larger and more tissue-disruptive incision that is traditionally used for plantar heel spur resection and plantar fascia releases.
Forty-one patients (46 feet) were selected for the study. The mean patient age was 47 years. Twenty-nine were considered obese with a body mass index greater than 30 kg/m(2). Patients were functionally and subjectively evaluated 4 weeks after surgery using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Rating Scale.
Results from the study show a significant improvement (P = .05 confidence level) 4 weeks postoperatively for the 41 patients (46 feet), compared to their preoperative condition. The mean pretest score was 33.6 (range 10-52); this score improved to 88.0 (range 50-100), 4 weeks postoperatively. There were no postoperative infections or complications.
The ultrasound-guided plantar fascia release technique is a practical surgical procedure for the relief of chronic plantar fascia pain because the surgeon is able to clearly visualize the plantar fascia by ultrasound. In addition, there is minimal disruption to surrounding tissue because small instruments are passed through a small 0.5-cm incision. The traditional open method of heel spur surgery, in contrast, uses a larger skin incision of 3 to 5 cm, followed by larger instruments to dissect to the plantar fascia.
超声引导下足底筋膜松解术能让外科医生清晰地看到手术部位的解剖结构。该技术通过一个0.5厘米的切口使用小型关节镜解剖器械,使外科医生避免了传统用于足跟骨刺切除和足底筋膜松解的更大且对组织破坏更大的切口。
选择41例患者(46只脚)进行研究。患者平均年龄为47岁。其中29例被认为肥胖,体重指数大于30kg/m²。术后4周,使用美国矫形足踝协会踝与后足评分量表对患者进行功能和主观评估。
研究结果显示,与术前情况相比,41例患者(46只脚)术后4周有显著改善(P = 0.05置信水平)。术前平均测试评分为33.6(范围10 - 52);术后4周该评分提高到88.0(范围50 - 100)。术后无感染或并发症。
超声引导下足底筋膜松解术是一种缓解慢性足底筋膜疼痛的实用手术方法,因为外科医生能够通过超声清晰地看到足底筋膜。此外,由于小器械通过一个0.5厘米的小切口进入,对周围组织的破坏最小。相比之下,传统的足跟骨刺开放手术方法使用3至5厘米的更大皮肤切口,然后使用更大的器械来解剖至足底筋膜。