Pfeiffer W H, Cracchiolo A
University of California, Los Angeles Medical Center.
J Bone Joint Surg Am. 1994 Aug;76(8):1222-30. doi: 10.2106/00004623-199408000-00012.
We reviewed the clinical results for thirty patients (thirty-two feet) who had had exploration and decompression of the posterior tibial nerve for the treatment of tarsal tunnel syndrome between 1982 and 1990. The average duration of follow-up was thirty-one months (range, twenty-four to 118 months). Most of the patients were female, and the average age was forty-seven years (range, thirteen to seventy-two years). Over-all, only fourteen (44 percent) of the thirty-two feet benefited markedly from the operative procedure (a good or excellent result). Of the five patients (five feet) who were completely satisfied, three had another lesion (a ganglion cyst, an accessory navicular bone, or a medial talocalcaneal coalition) in or near the tarsal tunnel that had been treated at the same time. Eleven patients (twelve feet [38 percent]) were clearly dissatisfied with the result and had no long-term relief of the pain (a poor result). The pain was decreased in six feet (19 percent), but the patients still had some pain and disability (a fair result). There were four complications (13 percent): three wound infections and one delay in wound-healing. Twenty-two feet had had preoperative electrodiagnostic studies; the results of eighteen studies were considered abnormal and supportive of a diagnosis of tarsal tunnel syndrome. However, there was no correlation between the clinical outcome at the latest follow-up visit and the results of these studies. Over-all, the patients in the current series had less improvement than those who have been reported on previously.2
我们回顾了1982年至1990年间因跗管综合征接受胫后神经探查及减压治疗的30例患者（32足）的临床结果。平均随访时间为31个月（范围24至118个月）。大多数患者为女性，平均年龄47岁（范围13至72岁）。总体而言，32足中只有14足（44%）从手术中明显获益（结果为良好或优秀）。在完全满意的5例患者（5足）中，3例在跗管内或其附近同时存在另一种病变（腱鞘囊肿、副舟骨或内侧距跟联合）。11例患者（12足[38%]）对结果明显不满意，疼痛未得到长期缓解（结果为差）。6足（19%）疼痛减轻，但患者仍有一些疼痛和功能障碍（结果为尚可）。有4例并发症（13%）：3例伤口感染和1例伤口愈合延迟。有22足术前行了电诊断检查；其中18例检查结果被认为异常，支持跗管综合征的诊断。然而，最近一次随访时的临床结果与这些检查结果之间并无相关性。总体而言，本系列患者的改善情况不如先前报道的患者。
