Mulhern Jennifer L, Protzman Nicole M, Summers N Jake, Brigido Stephen A
Coordinated Health, Bethlehem, Pennsylvania (JLM, NMP, NJS, SAB).
Martin Foot and Ankle, Lancaster, Pennsylvania (JLM).
Foot Ankle Spec. 2018 Aug;11(4):330-334. doi: 10.1177/1938640017733097. Epub 2017 Oct 12.
At present, there is a paucity of literature describing the clinical outcomes following a combined gastrocnemius recession and endoscopic plantar fasciotomy. The purpose of the present report is to describe our preliminary findings following a combined gastrocnemius recession and endoscopic plantar fasciotomy for the treatment of plantar fasciitis and gastrocnemius equinus recalcitrant to conservative therapy. Twenty-five consecutive ankles in 23 patients (age 51.2 ± 12.5 years, 4 men) met the inclusion and exclusion criteria. The average follow-up was 3.7 months. Compared across time, there were statistically significant improvements in pain, t(24) = 7.878, P < .001; dorsiflexion, t(24) = -6.125, P < .001; and eversion, t(23) = -3.610, P = .001. Plantar flexion and inversion remained similar across time ( P = .722 and P = .268, respectively). No statistically significant correlations were found between age and any of the postoperative outcome variables ( P ≥ .056) or body mass index and any of the postoperative outcome variables ( P ≥ .140). The authors believe that an isolated plantar fasciotomy alleviates symptoms in the majority of patients. When gastrocnemius equinus is also present, however, the authors advocate performing an open gastrocnemius recession as well. If the gastrocnemius pathology is not addressed, symptoms are likely to persist. The findings of the present report confirm the effectiveness of a combined gastrocnemius recession and endoscopic plantar fasciotomy to improve pain and range of motion.
Case series, Level IV: Retrospective.
目前，描述腓肠肌松解术联合内镜下足底筋膜切开术后临床结果的文献较少。本报告的目的是描述我们对腓肠肌松解术联合内镜下足底筋膜切开术治疗对保守治疗无效的足底筋膜炎和马蹄足的初步研究结果。23例患者（年龄51.2±12.5岁，4例男性）的25个连续踝关节符合纳入和排除标准。平均随访时间为3.7个月。随着时间推移，疼痛方面有统计学意义的改善，t(24)=7.878，P<.001；背屈方面，t(24)=-6.125，P<.001；外翻方面，t(23)=-3.610，P=.001。跖屈和内翻随时间变化保持相似（P分别为.722和.268）。未发现年龄与任何术后结果变量之间存在统计学意义的相关性（P≥.056），也未发现体重指数与任何术后结果变量之间存在统计学意义的相关性（P≥.140）。作者认为，单纯的足底筋膜切开术可缓解大多数患者的症状。然而，当同时存在马蹄足时作者也主张进行开放性腓肠肌松解术。如果不处理腓肠肌病变，症状可能会持续存在。本报告的研究结果证实了腓肠肌松解术联合内镜下足底筋膜切开术改善疼痛和活动范围的有效性。
病例系列，IV级：回顾性研究。
