Surgeon, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China.
Professor, Department of Orthopaedics, 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang, China.
J Foot Ankle Surg. 2020 Mar-Apr;59(2):280-285. doi: 10.1053/j.jfas.2019.08.015.
In this randomized retrospective study, 2 different endoscopic approaches were used to treat intractable plantar fasciitis with the aim to reduce complications and improve therapeutic effects. The lateral double incisions group included 23 feet in 22 patients, and the medial and lateral incisions group included 21 feet in 19 patients. Both groups were treated with endoscopy through the suprafascial approach. Patients were evaluated using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHS) and visual analog scale (VAS) preoperatively and 3, 6, 12, and 24 months postoperatively. At the final follow-up, the Roles-Maudsley (R-M) score was used to determine patient satisfaction. The AOFAS-AHS scores of the lateral double incisions group were 54.54 ± 7.02 preoperatively and 97.71 ± 3.67 postoperatively. Similarly, AOFAS-AHS scores in the medial and lateral incisions group were 55.52 ± 6.41 preoperatively and 96.64 ± 3.18 postoperatively. There was no significant difference in AOFAS-AHS scores between groups before and after surgery. The time to full weightbearing after surgery and the time to return to full athletic activities in the 2 groups showed no significant difference. The postoperative VAS scores were significantly lower than the preoperative values for both groups. However, no differences were noted in VAS scores or R-M scores postoperatively between the 2 groups. In the medial and lateral incisions group, 3 cases of injury of the first branch of the lateral plantar nerve occurred postoperatively. In conclusion, both endoscopic approaches are effective in the treatment of intractable plantar fasciitis. The lateral double incisions approach showed a lower incidence of nerve injury.
在这项随机回顾性研究中，使用了两种不同的内镜方法来治疗难治性足底筋膜炎，目的是减少并发症并提高治疗效果。外侧双切口组包括 22 例患者的 23 只脚，内侧和外侧切口组包括 19 例患者的 21 只脚。两组均采用筋膜上入路内镜治疗。术前和术后 3、6、12 和 24 个月分别采用美国矫形足踝协会踝后足量表（AOFAS-AHS）和视觉模拟量表（VAS）对患者进行评估。末次随访时，采用 Roles-Maudsley（R-M）评分评定患者满意度。外侧双切口组 AOFAS-AHS 评分术前为 54.54±7.02，术后为 97.71±3.67。内侧和外侧切口组 AOFAS-AHS 评分术前为 55.52±6.41，术后为 96.64±3.18。两组手术前后 AOFAS-AHS 评分无显著差异。两组术后完全负重时间和完全恢复运动时间无显著差异。两组术后 VAS 评分均明显低于术前，而术后 VAS 评分和 R-M 评分在两组间无差异。在内侧和外侧切口组，术后有 3 例发生外侧足底神经第一分支损伤。总之，两种内镜方法治疗难治性足底筋膜炎均有效。外侧双切口法神经损伤发生率较低。
