Nakajima Kenichiro
Department of Orthopedic Surgery, Yashio Central General Hospital, Saitama, Japan.
Foot Ankle Orthop. 2022 Jun 21;7(2):24730114221108104. doi: 10.1177/24730114221108104. eCollection 2022 Apr.
Studies on endoscopic calcaneal spur resection (CSR) without plantar fascial release (PFR) are limited. This study aimed to review the data of patients who underwent fluoroscopic and endoscopic CSR without PFR for plantar fasciitis with a calcaneal spur to assess the effectiveness of CSR.
Medical records of consecutive patients with plantar fasciitis with ≥2 mm calcaneal spur who underwent endoscopic CSR without PFR from November 2017 to December 2019 were reviewed. Patients with ≥2 years of follow-up were included, whereas those who underwent another surgery on the operated foot were excluded. Age, body mass index (BMI), follow-up duration, calcaneal spur length, duration to full weightbearing postoperatively, Japanese Society for Surgery of the Foot (JSSF) score, visual analog scale (VAS) score for pain, and complications were assessed.
The mean follow-up duration was 2.7 years. A total of 47 patients (31 female, 16 male; mean age, 56.4 years; mean BMI, 25.5) were included. The mean calcaneal spur length was 5.7 mm. The VAS score improved from 79.6 ± 12.9 mm preoperatively to 5.3 ± 7.3 mm postoperatively. The JSSF score improved from 54.0 ± 19.1 points preoperatively to 97.5 ± 5.7 points postoperatively (Wilcoxon signed-rank test, < .001, respectively). The mean duration to full weightbearing postoperatively was 4.4 ± 4.2 days. Two patients presented with tenderness, and one presented with hypesthesia at the portal site.
Endoscopic CSR without PFR resulted in good outcomes, early return to full weightbearing, and few complications in patients with plantar fasciitis with ≥2 mm calcaneal spur. The results suggested that CSR was sufficient to relieve symtoms and improve function. PFR may not be necessary for treating plantar fasciitis with calcaneal spur.
Level IV, retrospective case series.
关于不进行足底筋膜松解术（PFR）的内镜下跟骨骨刺切除术（CSR）的研究有限。本研究旨在回顾接受透视引导下和内镜下CSR且未行PFR治疗伴有跟骨骨刺的足底筋膜炎患者的数据，以评估CSR的有效性。
回顾了2017年11月至2019年12月期间连续接受内镜下CSR且未行PFR治疗伴有≥2mm跟骨骨刺的足底筋膜炎患者的病历。纳入随访时间≥2年的患者，排除在患足接受过其他手术的患者。评估患者的年龄、体重指数（BMI）、随访时间、跟骨骨刺长度、术后完全负重时间、日本足外科学会（JSSF）评分、疼痛视觉模拟量表（VAS）评分以及并发症情况。
平均随访时间为2.7年。共纳入47例患者（女性31例，男性16例；平均年龄56.4岁；平均BMI 25.5）。平均跟骨骨刺长度为5.7mm。VAS评分从术前的79.6±12.9mm改善至术后的5.3±7.3mm。JSSF评分从术前的54.0±19.1分提高至术后的97.5±5.7分（Wilcoxon符号秩检验，P均<0.001）。术后完全负重的平均时间为4.4±4.2天。2例患者出现切口部位压痛，1例出现感觉减退。
对于伴有≥2mm跟骨骨刺的足底筋膜炎患者，不进行PFR的内镜下CSR取得了良好的效果，患者能早期恢复完全负重，且并发症较少。结果表明CSR足以缓解症状并改善功能。治疗伴有跟骨骨刺的足底筋膜炎可能无需进行PFR。
IV级，回顾性病例系列研究。
