| Objective:By unified using extracorporal positioning needle knife therapy in the treatment of intractable calcaneodynia, observe and analyze the curative effect and the plantar stress change of patients after treated with different degree of plantar fascia release, to certain the value of using extracorporal positioning technology in the needle knife therapy operation. So lay the foundation for the further research of needle knife therapy standardized operation in treating calcaneodynia.Method:Clinical selection of 60 patients with calcaneodynia was between January 2014 and December 2014 in the third affiliated hospital of Beijing medical university, foot and Hand Surgery outpatient, all of them meet the eligibility criteria. According to the doctor-seeing order, patients were randomly divided into group A or group B using the single blind method. With the help of extracorporal positioning technology, group A was given release of 1/4 of plantar fascia treatment, and group B was half of the plantar fascia. Record subjective pain scale VAS score and Foot scan plantar pressure system dynamic testing results, comparison and analysis with the heel and metatarsal stress change, respectively before treatment, a week after treatment, and 3 months after treatment.Result:1.Before treatment group A, which release a quarter of plantar fascia, VAS score was 7.17±1.02 on average,1 week after treatment the score was 4.60±0.97,and 3 months later it was 2.47± 1.01.Respectively, group B,which release half of the plantar fascia, before treatment the VAS score was 7.50±0.94 on average, a week later the score was 4.43±1.19,and 3 months later it was 2.73±1.51. The follow-ups after treatment, two groups of VAS score was reduced, suggest that the two groups are effective treatment to relieve pain symptoms (P＜0.05).1 week after treatment and 3 months after treatment follow-up, the compare differences of VAS scores between the two groups had no significant statistical significance (P＞0.05), showed the two groups of treatment to relieve pain symptoms had no significant difference.2.By F-scan plantar pressure measurement system to measure the plantar pressure distribution, the results show that before treatment all groups the pressure under M2 and H were the largest, followed by Ml, M3,the M5 was the minimum.1 week and 3 month after treatment, all two groups, the dynamic average peak pressure (AVG) changes under H,M1,M3,M4 and M5 were statistically significant compared with before treatment (P＜0.05), only the dynamic average peak pressure changes (AVG) under M2 had no significant statistical significance (P＞0.05). After the treatment,comparison of dynamic average peak pressure (AVG) between the two groups in different period of follow-up had no difference (P＞0.05). In addition, group B with 1 case appeared arch height reduced, but didn’t present the whole structure of arch collapse. It means that before treatment, front-foot plantar peak pressure were under the heel and the three medial metatarsal bone head, after release treatment, the plantar peak pressure under the lateral metatarsal bone head increased, local stress increases.Conclusion:1. Part of plantar fascia release with needle knife could help to reduce local stress of the heel and metatarsal, thus to treat heel pain caused by plantar fascia inflammation.2. Release 1/4 or 1/2 of the plantar fascia had no significant difference on the improvement of the degree of pain symptoms.3. The long-term curative effect of needle knife therapy for the treatment of calcaneodynia were affirmative, and generally would not significantly reduce the longitudinal arch foot, but it will affect the foot structure’s overall biomechanical steady state. Whether it is possible to lead to some obvious foot dysfunction, longer follow-up is needed. |
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