第三趾底总神经卡压综合征

The compression syndrome of the third co mmon plantar digital nerves

目的 探讨第三趾底总神经卡压综合征的发病机理、诊断和治疗。方法 对 34例第三趾底总神经卡压综合征患者首选保守治疗 ,包括穿带跖骨垫软鞋 ,内服中药 ,中药水煎滤液直流通电导入 ,病患局部类固醇激素封闭等。保守治疗无效 15例及复发 3例作跖底深横韧带切断和神经松解术 ,5例加作神经瘤切除术。结果 34例首选保守治疗 ,19例有效 ,其中复发 6例 ,无效 15例。手术治疗 18例未见复发。结论 趾背伸试验和前足横向加压试验对临床诊断很有价值。保守治疗在早期通常是有效的。保守治疗失败 ,则应作跖底深横韧带切断、神经松解术和神经瘤切除术 。

ObjectiveTo study the pathogenesis,diagnosis and treatment of the compression syndrome of the third common plantar digital nerves .MethodsConservative methods were at first used for all the 34 cases of this disease.Tre atment methods includes:wearing shoes wi th soft bottom and metatarsal pad;the ad ministration of Chinese herbs;the applic ation of direct current iontherapy by fi ltering Chinese herbs and performing loc al injection therapy with steroid at the tenderness points.15 patients with no e ffect following conservative methods and other 3 recurrent cases were treated wi th section of deep transverse metatarsal ligament and relaxing the nerves compre ssion.Of the 18 cases,5 had additional t o excision of the neuroma.ResultsOf the 34 cases treated with conservativ e methods,19 had effective results,of wh ich 6 cases recurred,and 15 cases had no effect.18 cases treated with operation had no recurrence.ConclusionToe extending test and forefoot transver sely compressing test provide a valuable basis for diagnosis.Conservative treatm ent are usually effective in earlier pha se.If conservative treatment is not effe ctive,the transverse metatarsal ligament should be sectioned,nerves should be re laxed and the neuroma must be excised.Th e results of operative treatment are sat isfactory.