| 赵航宇,李璐兵,董一阳,等.关节镜与传统切开手术治疗跖筋膜炎型跟痛症的疗效比较.骨科,2026,17(5): 422-426. |
| 关节镜与传统切开手术治疗跖筋膜炎型跟痛症的疗效比较 |
| A comparative study of the efficacy of arthroscopic surgery and traditional open surgery in the treatment of plantar fasciitis-related heel pain |
| 投稿时间：2025-10-25 |
| DOI：10.3969/j.issn.1674-8573.2026.05.003 |
| 中文关键词: 跟痛症 跖筋膜炎 跟骨骨刺 关节镜 传统开放手术 跟骨减压 |
| 英文关键词: Heel pain Plantar fasciitis Calcaneal spur Arthroscopy Traditional open surgery Calcaneal decompression |
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| 中文摘要: |
| 目的 比较关节镜手术与传统切开手术治疗跖筋膜炎型跟痛症的临床疗效及并发症。方法 回顾性分析2022年1月至2024年12月我院48例经长期保守治疗无效行手术治疗的跖筋膜炎型跟痛症患者的病例资料，按手术方式不同分为关节镜组（20例）和开放手术组（28例），比较两组手术时间、住院时间、切口愈合情况，分别于术前及术后1、3、6、12个月采用疼痛视觉模拟量表（visual analogue scale，VAS）评分及Maryland足部评分评价临床疗效。结果 开放手术组手术时间少于关节镜组，住院时间长于关节镜组[（35.18±6.38） min vs. （41.62±8.21） min，（9.21±2.65） d vs. （7.35±2.31） d]，差异有统计学意义（P<0.05）。两组患者术后VAS评分显著降低（P<0.05），Maryland评分显著增加（P<0.05）。术后1个月关节镜组VAS及Maryland评分均显著优于开放手术组（P<0.05），术后3、6、12个月两组间VAS及Maryland评分差异无统计学意义（P>0.05）。关节镜组无手术切口并发症，开放手术组出现1例手术切口渗液延迟愈合及1例手术切口感染。结论 关节镜手术及传统开放手术治疗跖筋膜炎型跟痛症均具有较好疗效，关节镜手术在短期疗效、手术切口并发症、住院时间方面显著优于传统开放手术，但手术时间明显大于传统开放手术。 |
| 英文摘要: |
| Objective To compare the clinical efficacy and complications of arthroscopic surgery and traditional incision surgery in the treatment of plantar fasciitis heel pain. Methods The case data of 48 patients with plantar fasciitis type heel pain who had failed to respond to long-term conservative treatment and underwent surgical treatment in our hospital from January 2022 to December 2024 were retrospectively analyzed. They were divided into arthroscopic group (20 cases) and open surgery group (28 cases) according to different surgical methods. Operation time, hospital stay time, and incision healing between the two groups were compared. Clinical efficacy was evaluated by visual analog scale (VAS) score and Maryland foot score before surgery and 1, 3, 6, and 12 months after surgery respectively. Results The operating time in the open surgery group was shorter than that in the arthroscopic group, and the hospital stay was longer than that in the arthroscopic group [(35.18±6.38) min vs. (41.62±8.21) min, (9.21±2.65) d vs. (7.35±2.31) d], the difference was statistically significant (P<0.05). Postoperative VAS scores were significantly decreased in both groups (P<0.05), and Maryland scores were significantly increased (P<0.05). The VAS and Maryland scores in the arthroscopic group were significantly better than those in the open surgery group at 1 month after surgery (P<0.05), and there was no statistically significant difference in VAS and Maryland scores between the two groups at 3, 6, and 12 months after surgery (P>0.05). There were no surgical incision complications in the arthroscopic group, and 1 case of delayed healing of surgical incision exudate and 1 case of surgical incision infection occurred in the open surgery group. Conclusion Both arthroscopic surgery and traditional open surgery have good curative effects in the treatment of plantar fasciitis heel pain. Arthroscopic surgery is significantly superior to traditional open surgery in terms of short-term efficacy, surgical incision complications, and hospital stay time, but the operation time is significantly longer than traditional open surgery. |
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