跟骨结节骨赘对足跟部压力的影响及其与跟痛症的相关性

The effects of heel spur on the plantar pressure and heel pain

目的探讨跟骨结节骨赘对足跟部压力的影响程度及其与跟痛症的相关性。方法2005年2月至2007年4月，32例（48足）跟痛症伴跟骨结节骨赘患者、24例（33足）跟痛症无跟骨结节骨赘患者、18例（28足）跟骨结节骨赘无跟痛症患者及40名健康志愿者，分为病例1-3组及对照组。经站立和行走规范训练后，应用计算机化的足底压力分析系统（F-Scan Mobile，Tekscan，USA）测量分析比较四组问足跟部的静态峰值压力、动态平均峰值压力及动态最大峰值压力差异。结果在足跟部静态、动态平均及最大峰值压力测量中，四组间差异均有统计学意义（P〈0．05）。不同测量状态下，组间两两比较结果近似，即跟痛症伴跟骨结节骨赘组、跟骨结节骨赘无跟痛症组足跟部峰值压力较跟痛症无跟骨结节骨赘组和对照组明显增高，但增加的程度不同，增幅最大是动态最大的峰值压力，跟痛症伴跟骨结节骨赘组和跟骨结节骨赘无跟痛症组分别达到（638．8±172．3）kPa和（510．2±85．6）kPa，而跟痛症无跟骨结节骨赘组和对照组仅为（382．5±61．3）kPa和（395．6±62．3）kPa。结论跟骨结节骨赘可明显增加足跟部压力，跟骨结节骨赘伴跟痛症时压力增高更为显著，而跟痛症无跟骨结节骨赘时，足跟部压力并未明显增高。

Objective To evaluate the effect of heel spur on the plantar pressure and heel pain. Methods From February 2005 to April 2007, 32 cases （48 heels） with plantar heel pain and heel spur, 24 cases （33 heels） with plantar heel pain but not heel spur, 18 cases （28 heels） with heel spur but not plantar heel pain, 40 health volunteers were divided into three groups and control group. In this study, the peak plantar pressure of resting state, the mean peak plantar pressure and the highest peak plantar pressure of dynamic was measured using F-Scan Mobile. Results Compared with the other two groups, patients with plantar heel pain and heel spur and patients heel spur but not plantar heel pain had higher foot pressures measured as peak plantar pressure of resting state and mean peak plantar pressure of dynamic under heel（P 〈 0.05）. Furthermore, when measuring the maximum pressure of dynamic, the patients with heel pain and heel spur also had the most elevated pressures, significantly higher than patients in other groups. Conclusion These results show that heel spur can make plantar pressure increased, especially in the patients with heel spur and heel pain. The plantar patients with heel pain but not heel spur dose not have any increased plantar pressure.