Baxter D E, Thigpen C M
Foot Ankle. 1984 Jul-Aug;5(1):16-25. doi: 10.1177/107110078400500103.
In 6 years through 1982, the authors performed 34 operative cases in 26 patients with recalcitrant heel pain. The operative procedure involves an isolated neurolysis of the mixed nerve supplying the abductor digiti quinti muscle as it passes beneath the abductor hallucis muscle and beneath the medial ridge of the calcaneus. The deep fascia of the abductor hallucis muscle is released routinely, and an impinging heel spur or tight plantar fascia is partially removed or released if it is causing entrapment of the nerve. The biomechanical pathogenesis of heel pain in relation to pes planus and pes cavus predisposing to an entrapment neuropathy is described, and the anatomy of the heel in relation to the nerve distribution is clarified and well illustrated. Of the 34 operated heels, 32 had good results and two had poor results. Heel pain can cause total disability in the working population and may jeopardize one's employment or professional athletic career. The authors believe operative treatment has a place in the care of recalcitrant heel pain and that an entrapment neuropathy is an etiological factor in heel pain.
截至1982年的6年间，作者对26例顽固性足跟痛患者进行了34例手术。手术操作包括对供应小趾展肌的混合神经进行单独的松解，该神经在拇展肌下方和跟骨内侧嵴下方通过。常规松解拇展肌的深筋膜，如果导致神经卡压的足跟骨刺或紧张的跖腱膜，则部分切除或松解。描述了扁平足和高弓足易导致卡压性神经病变的足跟痛的生物力学发病机制，并阐明并详细说明了足跟与神经分布相关的解剖结构。在34只接受手术的足跟中，32只效果良好，2只效果不佳。足跟痛会导致劳动人口完全丧失能力，并可能危及一个人的就业或职业运动生涯。作者认为手术治疗在顽固性足跟痛的治疗中占有一席之地，并且卡压性神经病变是足跟痛的一个病因。
