足底外侧筋膜病：第五跖骨基底部创伤性疼痛的一个经常被忽视的原因

Q2 Health Professions

Foot Pub Date : 2024-08-23 DOI:10.1016/j.foot.2024.102125

Jens Vanlommel , Nathalie van Beek , Anne Van Riet , Stefaan Verfaillie

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引用次数: 0

摘要

背景侧索性足底筋膜炎（LCPF）会引起第五跖骨基底部的创伤性疼痛。本研究评估了保守疗法（PRP + 铸模）对 LCPF 的疗效。方法通过病史、临床诊断和超声成像确定 LCPF。所有患者都在第五跖骨基底部近端注射了贫白细胞的 PRP，然后打上石膏行走三周。在治疗后 6 周、12 周和 2 年分别进行随访问卷调查，包括 NRS、AOFAS 和足部功能指数 (FFI)。超声波检查结果显示，MT 5 插入点的足底外侧筋膜松弛、增厚，腓肠肌肌腱正常。从治疗前（NRSrest 55.1 ± 29.6，NRSactivity 79.20 ± 15.5）到治疗后 6 周（NRSrest：22.4 ± 23.6，p = 0.03；NRSactivity：38.6 ± 30.3，p = 0.005），疼痛明显减轻。与治疗前（42.6 ± 16.7）相比，FFI 在 12 周（25.7 ± 25.7）和 2 年（9.1 ± 8.5）之间均有改善。事实证明，注射 PRP 后使用行走石膏可在六周内有效缓解 LCPF 症状，并可持续缓解长达两年。

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Lateral plantar fasciopathy: An frequently overlooked cause of atraumatic pain at the fifth metatarsal base

Background

Lateral cord plantar fasciitis (LCPF) causes atraumatic pain at the fifth metatarsal base. This study assesses the outcomes of a conservative treatment (PRP + casting) on LCPF.

Methods

Medical history, clinical diagnosis, and ultrasound imaging were used to determine LPCF. All patients received a leucocyte-poor PRP injection at the proximal part of the fifth metatarsal base, followed by three weeks in a walking cast. Follow-up questionnaires, encompassing NRS, AOFAS, and Foot Functioning Index (FFI), were administered at 6 weeks, 12 weeks, and 2 years post-treatment.

Results

Ten patients were enrolled in the study. Ultrasound findings revealed hyposonant and thickened lateral fascia plantaris at the MT 5 insertion point with normal peronei tendons. There was a notable reduction in pain from pre-treatment (NRS_rest 55.1 ± 29.6, NRS_activity 79.20 ± 15.5) to 6 weeks post-treatment (NRS_rest: 22.4 ± 23.6, p = 0.03; NRS_activity: 38.6 ± 30.3, p = 0.005). FFI indicated an improvement between 12 weeks (25.7 ± 25.7) and 2 years (9.1 ± 8.5) compared to pre-treatment (42.6 ± 16.7).

Conclusion

Ultrasound stands out as the preferred diagnostic method for identifying LCPF. A PRP injection followed by a walking cast proves effective in relieving LCPF symptoms within six weeks with sustained relief up to two years.

Level of evidence

Level IV

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来源期刊

Foot Health Professions-Podiatry

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： The Foot is an international peer-reviewed journal covering all aspects of scientific approaches and medical and surgical treatment of the foot. The Foot aims to provide a multidisciplinary platform for all specialties involved in treating disorders of the foot. At present it is the only journal which provides this inter-disciplinary opportunity. Primary research papers cover a wide range of disorders of the foot and their treatment, including diabetes, vascular disease, neurological, dermatological and infectious conditions, sports injuries, biomechanics, bioengineering, orthoses and prostheses.