Wang Chung-Li, Chen Pei-Yu, Yang Kai-Chiang, Wu Hsing-Cheng, Wang Chen-Chie
Professor, Department of Orthopedic Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Attending, Department of Orthopedic Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Foot Ankle Surg. 2019 Sep;58(5):855-860. doi: 10.1053/j.jfas.2018.12.023. Epub 2019 Jul 23.
Posterior heel pain is a common complaint that is often caused by overuse injuries. In such cases, the retrocalcaneal bursa is compressed and chafed repeatedly, leading to local inflammation. Sonography is a popular imaging tool used to study the pathology of soft tissues, and it can be used to assist in diagnosing bursitis because of its accuracy. Herein, we report an innovative method to treat retrocalcaneal bursitis under ultrasound guidance. Ten patients with posterior heel pain for >6 months who failed conservative treatment received this ultrasound-guided minimally invasive surgery. An endoscopic puncher and burr were inserted under ultrasound guidance via a stabbing wound, and the swollen retrocalcaneal bursa and bony prominence were resected. The patients were able to ambulate and undergo a rehabilitation program 2 weeks postoperatively. In the patients who underwent this ultrasound-guided minimally invasive surgery, both the average surgical time and average hospital stay were shorter than in those (n = 12) who underwent open surgery. In outcome rating assessment, the American Orthopaedic Foot & Ankle Society (AOFAS) pain score and total AOFAS ankle-hindfoot score were improved in the ultrasound-guided minimally invasive surgery group compared to the open surgery group at 2 months postoperatively. Other advantages included lesser wound pain, shorter hospital stay, faster recovery time, and minimal blood loss. Accordingly, ultrasound-guided surgery appears to be a good option for the treatment of retrocalcaneal bursitis.
足跟后部疼痛是一种常见的病症,通常由过度使用性损伤引起。在这种情况下,跟腱后滑囊会反复受到挤压和摩擦,导致局部炎症。超声检查是一种常用的软组织病理学成像工具,因其准确性可用于辅助诊断滑囊炎。在此,我们报告一种在超声引导下治疗跟腱后滑囊炎的创新方法。10例足跟后部疼痛超过6个月且保守治疗无效的患者接受了这种超声引导下的微创手术。在内镜引导下,通过刺伤伤口插入内镜穿孔器和磨钻,切除肿胀的跟腱后滑囊和骨突。患者术后2周即可行走并接受康复治疗。接受这种超声引导下微创手术的患者,平均手术时间和平均住院时间均短于接受开放手术的患者(n = 12)。在疗效评估中,与开放手术组相比,超声引导下微创手术组在术后2个月时美国矫形足踝协会(AOFAS)疼痛评分和AOFAS踝后足总评分均有所改善。其他优点包括伤口疼痛较轻、住院时间较短、恢复时间较快以及失血极少。因此,超声引导下手术似乎是治疗跟腱后滑囊炎的一个不错选择。