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部分筋膜切除术是治疗有症状的足底纤维瘤病的一种有效治疗选择。

Partial fasciectomy is a useful treatment option for symptomatic plantar fibromatosis.

作者信息

Kadir Haji Khairul Abd, Chandrasekar Coonoor R

机构信息

Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, United Kingdom.

Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, United Kingdom.

出版信息

Foot (Edinb). 2017 Jun;31:31-34. doi: 10.1016/j.foot.2017.02.002. Epub 2017 Feb 21.

Abstract

Plantar fibromatosis is a rare, benign fibroproliferative disorder of the plantar fascia. It is considered as a low-grade tumour and it can be locally aggressive. It can present as painful swelling with impairment of local function. Upon failure of non-operative management, surgical treatment options include total fasciectomy or partial fasciectomy. Although surgical excision is the mainstay of treatment, recurrence rate can be up to 60%. The aim of this study was to determine the recurrence and complication rates of surgically treated plantar fibromatosis. A retrospective study was conducted involving patients who had a confirmed diagnosis and excision of plantar fibromatosis treated in our institution between 2011 and 2016. Demographic data, follow-up duration, recurrence and complications were reviewed. Eighteen patients underwent 19 operations. Mean age was 41.3 years (20-57). There were 12 male patients. The main presenting features were pain, swelling and impairment of function. They were investigated by ultrasound scan (12 feet, 63%) and/or magnetic resonance imaging (8 feet, 42%). Two patients (11%) had prior surgery at other institutions whilst 3 patients (17%) had multiple nodules at presentation. All patients underwent partial fasciectomy of the plantar fibromatosis. At up to 5 years follow-up, one patient (6%) had a recurrence in our series whilst 3 patients (17%) had scar related problems (2 patients with scar pain and one patient had hypersensitive scar that resolved after 12 months). Symptomatic plantar fibromatosis can be effectively treated with partial plantar fasciectomy.

摘要

足底纤维瘤病是一种罕见的足底筋膜良性纤维增生性疾病。它被认为是一种低度恶性肿瘤,具有局部侵袭性。可表现为疼痛性肿胀并伴有局部功能障碍。非手术治疗失败后,手术治疗选择包括全筋膜切除术或部分筋膜切除术。尽管手术切除是主要治疗方法,但复发率可达60%。本研究的目的是确定手术治疗足底纤维瘤病的复发率和并发症发生率。进行了一项回顾性研究,纳入了2011年至2016年在我院确诊并接受足底纤维瘤病切除治疗的患者。回顾了人口统计学数据、随访时间、复发情况和并发症。18例患者接受了19次手术。平均年龄为41.3岁(20 - 57岁)。男性患者12例。主要表现为疼痛、肿胀和功能障碍。他们接受了超声检查(12足,63%)和/或磁共振成像检查(8足,42%)。2例患者(11%)曾在其他机构接受过手术,3例患者(17%)初诊时有多个结节。所有患者均接受了足底纤维瘤病的部分筋膜切除术。在长达5年的随访中,本系列中有1例患者(6%)复发,3例患者(17%)出现与瘢痕相关的问题(2例瘢痕疼痛,1例瘢痕过敏,12个月后缓解)。有症状的足底纤维瘤病可通过部分足底筋膜切除术有效治疗。

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