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超声引导下跗管综合征松解术的疗效:81 例患者的随访至少 18 个月的回顾性研究。

Results of ultrasound-guided release of tarsal tunnel syndrome: a review of 81 cases with a minimum follow-up of 18 months.

机构信息

Department of Podiatry, Faculty of Health Sciences, University of La Salle, Institute Avanfi, 28020, Madrid, Spain.

Avanfi Institute and Unit for Ultrasound-guided Surgery, Hospital Beata María Ana, Calle Orense 32, 1, 28020, Madrid, Spain.

出版信息

J Orthop Surg Res. 2020 Jan 28;15(1):30. doi: 10.1186/s13018-020-1559-1.

Abstract

BACKGROUND

This study aims to analyse the clinical results of ultrasound-guided surgery for the decompression of the tibial nerve, including its distal medial and lateral branches, to treat tarsal tunnel syndrome. These structures are the complete flexor retinaculum and the deep fascia of the abductor hallucis muscle, including individualised release of the medial and lateral plantar nerve tunnels.

METHOD

This is a retrospective review of 81 patients (36 men and 45 women) with an average age of 41 years old (32-62) and an average clinical course of 31 months (8-96) compatible with idiopathic tarsal tunnel syndrome, who underwent ultrasound-guided decompression of the proximal and distal tarsal tunnel between February 2015 and November 2017 (both months included), with a minimum follow-up of 18 months.

RESULTS

Based on the Takakura et al. scale for the 81 patients, 76.54% obtained excellent results, 13.58% good results, and 9.87% poor results. The patients with the longest course of symptoms displayed the worst results.

CONCLUSION

Although 9% of patients did not improve, ultrasound-guided tarsal tunnel release might be a viable alternative to conventional open approaches.

摘要

背景

本研究旨在分析超声引导下手术治疗跗管综合征的临床效果,包括对胫神经的远内侧和远外侧支的减压,这些结构包括完整的屈肌支持带和拇展肌的深筋膜,包括内侧和外侧足底神经隧道的个体化松解。

方法

这是对 81 例(36 名男性和 45 名女性)平均年龄为 41 岁(32-62 岁)、平均临床病程为 31 个月(8-96 个月)的特发性跗管综合征患者进行的回顾性研究,这些患者在 2015 年 2 月至 2017 年 11 月(均包括在内)期间接受了超声引导下的近端和远端跗管减压治疗,随访时间至少为 18 个月。

结果

根据高仓等人的评分标准,81 例患者中 76.54%的患者取得了优秀的结果,13.58%的患者取得了良好的结果,9.87%的患者取得了较差的结果。症状持续时间最长的患者结果最差。

结论

尽管 9%的患者没有改善,但超声引导下的跗管松解术可能是传统开放性手术的一种可行替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b55/6988231/d8f9eb8554d3/13018_2020_1559_Fig1_HTML.jpg

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