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内镜下足底筋膜切开术改善术后早期效果:内镜下与开放性足底筋膜切开术术后结果的回顾性比较

Endoscopic Plantar Fasciotomy Improves Early Postoperative Results: A Retrospective Comparison of Outcomes After Endoscopic Versus Open Plantar Fasciotomy.

作者信息

Chou Andrew Chia Chen, Ng Sean Yung Chuan, Koo Kevin Oon Thien

机构信息

Duke-NUS Graduate Medical School, Singapore.

Duke-NUS Graduate Medical School, Singapore; Foot and Ankle Service, Department of Orthopaedic Surgery, Singapore General Hospital, Outram Park, Singapore.

出版信息

J Foot Ankle Surg. 2016 Jan-Feb;55(1):9-15. doi: 10.1053/j.jfas.2015.02.005. Epub 2015 May 23.

Abstract

Plantar fasciotomy is offered to patients with recalcitrant plantar fasciitis. Few studies have characterized the functional outcomes over time for the endoscopic approach compared with the open approach. We hypothesized that patients undergoing endoscopic surgery will have better postoperative functional outcomes early in the postoperative period but equivalent long-term outcomes compared with patients undergoing open surgery. We analyzed the prospectively collected data of all patients undergoing plantar fasciotomy at our institution from December 2007 to August 2014. A total of 42 feet of 38 patients were included in the analysis. The clinical data were collected preoperatively and at 3 and 6 months and 1 year. The functional outcomes analyzed included the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale, the Medical Outcomes Study, Short-Form, 36-item Health Survey, and patient satisfaction and expectations. Patients undergoing endoscopic surgery had significantly greater American Orthopaedic Foot and Ankle Society Ankle-Hindfoot and SF-36 Health Survey scores and lower pain scores at the 3-month period. They were also significantly more likely to be satisfied with and have had their expectations met by surgery. Compared with the open approach, the patients who had undergone endoscopic plantar fasciotomy experienced significantly greater improvements in the subjective and objective functional outcomes, with less pain and greater satisfaction, and had had their expectations met earlier in the recovery period, with equivalent long-term outcomes, compared with the patients who had undergone open plantar fasciotomy.

摘要

对于顽固性足底筋膜炎患者可采用足底筋膜切开术。与开放式手术相比,很少有研究描述内镜手术随时间推移的功能结果。我们推测,与接受开放式手术的患者相比,接受内镜手术的患者在术后早期会有更好的功能结果,但长期结果相当。我们分析了2007年12月至2014年8月在我院接受足底筋膜切开术的所有患者的前瞻性收集数据。分析共纳入38例患者的42只脚。术前、术后3个月、6个月和1年收集临床数据。分析的功能结果包括美国矫形足踝协会踝-后足评分、医学结果研究简表36项健康调查以及患者满意度和期望。接受内镜手术的患者在术后3个月时美国矫形足踝协会踝-后足评分和SF-36健康调查得分显著更高,疼痛评分更低。他们也更有可能对手术感到满意并达到预期。与开放式手术相比,接受内镜足底筋膜切开术的患者在主观和客观功能结果方面有显著更大的改善,疼痛更少,满意度更高,并且在恢复期更早达到预期,与接受开放式足底筋膜切开术的患者相比,长期结果相当。

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