Choice of treatment for «hard-to-treat» cases of plantar fasciitis

V. Lazarenko, V. Mishustin, E. A. Bobrovskaya
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Abstract

Objective: to develop an algorithm for choosing a treatment method for "difficult" cases of plantar fasciitis. Materials and methods. The clinical research included 40 patients with plantar fasciitis. These patients had so-called «hard-to-treat» cases of plantar fasciitis. These are: patients previously treated with local hormone injections or FSWT. There was no effect from the treatment. Depends on the clinical picture, the patients were divided into 3 groups: the main group (n=20) - patients with «hard-to-treat» cases, who underwent combined focused(FSWT) and radial shock wave therapy(RSWT); compare group (n=10) - patients who received only FSWT; control group(n=10) - patients who underwent local injection of hormones. Results. It was found that that the complex treatment of plantar fasciitis with radial and focused shock wave therapy in patients in «difficult cases» allows obtaining satisfactory results in 97% of patients 4 weeks after the end of treatment. This is significantly higher than with treatment with only focused shock wave and local hormone therapy (p<0.05). Moreover, hormone therapy was effective only in 4 (40%) patients who had previously received shock wave therapy. In patients with previous local injection of hormones, it was ineffective. Only focused shock wave therapy relieved pain syndrome in 6 (60%) patients. Conclusion. The study of the results of the treatment of «difficult» cases of plantar fasciitis by the method of radial and focused shock waves in combination, as well as only by the method of focused shock wave therapy and local injection with hormones will allow us to form an algorithm for the treatment of such patients to increase the number of satisfactory results.
“难以治疗”足底筋膜炎病例的治疗选择
目的:探讨足底筋膜炎“疑难”病例治疗方法的选择算法。材料和方法。对40例足底筋膜炎患者进行临床研究。这些患者患有所谓的“难以治疗”的足底筋膜炎。这些是:以前接受过局部激素注射或FSWT治疗的患者。这种治疗没有效果。根据临床情况,将患者分为3组:主要组(n=20) -“难以治疗”的患者,他们接受了联合聚焦(FSWT)和径向冲击波治疗(RSWT);对照组(n=10) -仅接受FSWT的患者;对照组(n=10) -局部注射激素的患者。结果。研究发现,在“疑难病例”患者中,放射和聚焦冲击波治疗足底筋膜炎的综合治疗可使97%的患者在治疗结束后4周获得满意的结果。这明显高于仅集中冲击波治疗和局部激素治疗(p<0.05)。此外,激素治疗仅对先前接受过冲击波治疗的4例(40%)患者有效。既往局部注射激素的患者无效。仅集中冲击波治疗缓解了6例(60%)患者的疼痛综合征。结论。通过对放射冲击波与聚焦冲击波联合治疗足底筋膜炎“难治性”病例,以及仅采用聚焦冲击波治疗加局部注射激素的方法的治疗结果的研究,使我们能够形成一种治疗此类患者的算法,以增加满意结果的数量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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