摘要
目的探讨采用骨水泥注入对不同类型跟痛症的治疗效果。方法选择2017年11月至2022年12月在福建医科大学附属泉州市第一医院和温州医科大学附属乐清医院骨科门诊就诊跟痛症患者25例,根据影像学资料,将患足跟骨有无骨刺分为骨刺组(A1组)7例和无骨刺组(A2组)18例;根据术前跟骨疼痛定位点分为跟下疼痛组(B1组)13例,跟内侧疼痛组(B2组)6例和跟外侧疼痛组(B3组)6例。所有病例均在局麻下行跟痛点部位骨水泥注入,术后进行为期一年的随访,采用视觉模拟评分(VAS)和美国足外科协会(AOFAS)踝-后足评分法分别在术前、术后2周、术后1年3个时间点对A1、A2、B1、B2、B3各组受试者进行评分,采用配对t检验分析每组患者治疗前后各项观察指标变化,以独立样本t检验分析A1组与A2组患者之间治疗前后各项观察指标变化,以F检验分析B1组、B2组、B3组患者各项观察指标变化,并在术后1年随访时进行临床疗效评价。结果术后2周A1组VAS评分(4.07±1.43)高于A2组(2.81±1.54);A1组术后2周AOFAS踝-后足评分(81.78±7.81)低于A2组(90.29±6.18),差异均有统计学意义(t=2.531、2.860,P<0.05);术后1年A1组VAS评分(0.93±1.10)低于A2组(1.79±1.55);A1组术后1年AOFAS踝-后足评分(94.00±7.28)高于A2组(88.33±9.77);差异均无统计学意义(t=1.546、1.579,P>0.05);B1、B2、B3组术后2周VAS和AOFAS踝-后足评分为(2.73±1.41、2.58±1.63、2.33±1.89,85.00±6.14、83.67±7.06、82.83±13.48),差异均无统计学意义(F=0.132、0.145,P>005);B1、B2、B3组术后1年VAS和AOFAS踝-后足评分为(1.27±1.24、1.75±1.70、1.67±1.89,91.39±7.21、86.00±9.57、90.67±13.41),差异均无统计学意义(F=0.148、0.686,P>0.05)。结论骨水泥注入对于伴有或不伴骨刺以及不同部位的跟骨疼痛均有缓解疼痛作用,长期效果差异无统计学意义,提示对于不同类型的跟痛,均可采用此方法治疗。
Objective To explore the therapeutic effects of bone cement injection for different types of heel pain.Methods A total of 25 patients with heel pain who visited the Orthopedic Outpatient Clinics of Quanzhou First Hospital affiliated to Fujian Medical University and Yueqing Hospital affiliated to Wenzhou Medical University from November 2017 to December 2022 were selected.Based on imaging data,the patients were divided into the bone spur group(n=7,A1 group)and the no bone spur group(n=18,A2 group).According to preoperative localization of heel pain,they were further categorized into the plantar pain group(n=13,B1 group),the medial pain group(n=6,B2 group),and the lateral pain group(n=6,B3 group).All cases underwent bone cement injection at the painful points of the heel under local anesthesia.Postoperative follow-up was conducted for one year,visual analogue score(VAS)and American Foot and Ankle Society(AOFAS)ankle-hindfoot score were used to evaluate A1,A2,B1,B2,and B3 groups of subjects at three time points:preoperation,2 weeks postoperation,and 1 year postoperation,respectively.The paired t-test was used to analyze the changes of the observed indexes between the patients in the A1 group and the A2 group before and after treatment,and the F-test was used to analyze the changes of the observed indexes between the patients in the B1 group,B2 group and B3 groups.Clinical efficacy was also assessed during the one-year follow-up.Results At 2nd week postoperation,the VAS score of group A1(4.07±1.43)was higher than that of group A2(2.81±1.54);the AOFAS ankle-hindfoot score of group A1(81.78±7.81)was significantly lower than that of group A2(90.29±6.18)at 2nd week postoperation(t=2.531,2.860,P<0.05);at 1 year postoperation,the VAS score of group A1(0.93±1.10)was significantly lower than that of group A2(1.79±1.55);and the AOFAS ankle-hindfoot score of group A1(94.00±7.28)was significantly higher than group A2(88.33±9.77,t=1.546,1.579,P>0.05).The postoperative 2-week VAS and AOFAS ankle-hindfoot scores in groups B1,B2,and B3 were 2.73±1.41,2.58±1.63,2.33±1.89,85.00±6.14,83.67±7.06,82.83±13.48,showing no statistically significant differences(F=0.132,0.145,P>0.05);the postoperative 1-year VAS and AOFAS ankle-hindfoot scores in groups B1,B2,and B3 were 1.27±1.24,1.75±1.70,1.67±1.89,91.39±7.21,86.00±9.57,90.67±13.41,showing no statistically significant differences(F=0.148,0.686,P>0.05).The results showed that at 2nd week postoperation,the treatment effect of the bone spur-free group was better than that of the bone spur group,but there was no significant difference in long-term effects;there was no significant difference in short-and long-term effects for treating calcaneal pain in different locations.Conclusion Bone cement injection has a pain-relieving effect on calcaneal pain with or without bone spurs and in different parts,and there is no significant difference in long-term effect,suggesting that this method can be used for different types of calcaneal pain.
作者
郑立程
季滢瑶
金亚平
李科伦
吴纪奎
郑旭浩
吴珊鹏
Zheng Licheng;Ji Yingyao;Jin Yapin;Li Kelun;Wu Jikui;Zheng Xuhao;Wu Shanpeng(Department of Orthopedics,Yueqing Hospital Affiliated to Wenzhou Medical University,Yueqing 325600,China)
出处
《中华实验外科杂志》
2025年第6期1139-1142,共4页
Chinese Journal of Experimental Surgery
关键词
骨水泥
跟痛症
治疗效果
Bone cement
Heel pain
Treatment effect
