BACKGROUND The accessory bones are common bone variations around the feet and ankles,which usually originate from nonunion of the secondary ossification center adjacent to the main bone mass,and most of them remain as...BACKGROUND The accessory bones are common bone variations around the feet and ankles,which usually originate from nonunion of the secondary ossification center adjacent to the main bone mass,and most of them remain asymptomatic.Os subcalcis is an accessory bone at the plantar aspect of the calcaneus,which is located just posterior to the insertion of the plantar fascia.Focal bone formation at the calcaneal plantar pole with heel pain has rarely been reported.CASE SUMMARY A 55-year-old man presented to our clinic with left plantar heel pain and a progressive swelling for 8 years.X-ray,computer tomography and magnetic resonance imaging showed a large os subcalcison the plantar side of the calcaneus,located at the insertion of the plantar fascia.He underwent surgical excision of the lesion.Microscopically the bony trabeculae were intermingled with fat and covered with cartilage.CONCLUSION This is a rare case with accessory os subcalcis leading to heel pain.It highlights the awareness of os subcalcis and helps avoid future misdiagnosis of heel pain.展开更多
BACKGROUND Heel pain is a common orthopaedic complaint,and if left untreated can be a source of chronic morbidity.Accurate diagnosis can be challenging,owing to the complex anatomy and multiple pain generators present...BACKGROUND Heel pain is a common orthopaedic complaint,and if left untreated can be a source of chronic morbidity.Accurate diagnosis can be challenging,owing to the complex anatomy and multiple pain generators present in the foot.We aim to share our clinical experience managing an unusual case of chronic heel pain secondary to osteochondroma.CASE SUMMARY A 41-year-old obese male who works as a porter presented with a long-standing history of left plantar heel pain.He was assessed to have point tenderness over the plantar insertion of the calcaneus as well as a positive Silfverski?ld test.He was treated for plantar fasciitis and tight gastrocnemius but failed conservative therapies as well as surgical intervention.Magnetic resonance imaging revealed the presence of a pedunculated bony protrusion over the plantar aspect of the calcaneus.The decision was made for excision of the osteochondroma,and the patient has been pain-free since.CONCLUSION Osteochondromas are rarely symptomatic in skeletally mature patients.While most are benign with a very low risk of malignant transformation,surgical excision can yield excellent results and significant pain relief in symptomatic patients.展开更多
Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger＇s heel, tennis heal, policeman＇s heel are used to describe it. Mechanical factors are the most common etiology of heel pa...Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger＇s heel, tennis heal, policeman＇s heel are used to describe it. Mechanical factors are the most common etiology of heel pain. Common causes of hell pain includes： Plantar Fasciitis, Heel Spur, Sever＇s Disease, Heel bump, Achilles Tendinopathy, Heel neuritis, Heel bursitis. The diagnosis is mostly based on clinical examination. Normally, the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis. Several therapies exist including rest, physical therapy, stretching, and change in footwear, arch supports, orthotics, night splints, anti-inflammatory agents, and surgery. Almost all patients respond to conservative nonsurgical therapy. Surgery is the last treatment option if all other treatments had failed. Rest, ice, massage, the use of correct exercise and complying with a doctor＇s advice all play important part in helping to recover from this hell pain condition, but getting good quality, suitable shoes with the appropriate amount of support for the whole foot is the most important.展开更多
Objective： To observe the clinical efficacy of Chinese herbal fumigation plus beating with mulberry stick in treating heel pain. Methods： Sixty patients with heel pain were randomized into a treatment group and a c...Objective： To observe the clinical efficacy of Chinese herbal fumigation plus beating with mulberry stick in treating heel pain. Methods： Sixty patients with heel pain were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by Chinese herbal fumigation plus beating with mulberry stick, and the control group was by orally taking Diclofenac Sodium Sustained Release Tablets plus external use of She Xiong Zhen Tong Gao （Moschus Analgesic Plaster）. After one treatment course, the visual analogue scale （VAS） was used to observe the change of pain, and the clinical efficacies were also evaluated. Results： After intervention, the improvement of VAS score in the treatment group was more significant than that in the control group （P〈0.01）. The total effective rate of the treatment group was significantly higher than that of the control group （P〈0.01）. Conclusion： Chinese herbal fumigation plus beating with mulberry stick can produce a higher clinical efficacy than orally taking Diclofenac Sodium Sustained Release Tablets in treating heel pain.展开更多
目的探讨活血通络汤外洗联合冲击波治疗跟痛症的临床效果。方法选取2020年1月—2022年12月武警第一机动总队医院收治的80例跟痛症患者为研究对象。按照治疗方法不同分为两组,各40例。对照组采用局部冲击波治疗,观察组在对照组治疗的基...目的探讨活血通络汤外洗联合冲击波治疗跟痛症的临床效果。方法选取2020年1月—2022年12月武警第一机动总队医院收治的80例跟痛症患者为研究对象。按照治疗方法不同分为两组,各40例。对照组采用局部冲击波治疗,观察组在对照组治疗的基础上结合活血通络汤外洗治疗。比较两组治疗后每日跟痛持续时间、视觉模拟评分法(Visual Analog Scale,VAS)评分、Maryland足跟功能评分,统计两组治疗效果、并发症发生率,并随访1年,比较复发率。结果治疗后,观察组每日跟痛持续时间为(0.6±0.2)h,短于对照组的(5.6±1.8)h,差异有统计学意义(t=17.329,P<0.05)。治疗后,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后,两组Maryland足跟功能评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P均<0.05)。观察组治疗总有效率高于对照组,1年复发率低于对照组,差异有统计学意义(P均<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论跟痛症患者在使用冲击波治疗基础上联合应用活血通络汤外洗,可快速缓解患者足跟部疼痛,改善足部功能,提高治疗有效率,降低复发率,且不良反应少,安全性高。展开更多
目的 评价不同补充和替代医学(complementary and alternative medicine, CAM)疗法对缓解新生儿足跟采血疼痛的应用效果。方法 计算机检索PubMed、Embase、Web of Science、Cochrane、CINAHL、中国知网、维普、万方、中国生物医学文献...目的 评价不同补充和替代医学(complementary and alternative medicine, CAM)疗法对缓解新生儿足跟采血疼痛的应用效果。方法 计算机检索PubMed、Embase、Web of Science、Cochrane、CINAHL、中国知网、维普、万方、中国生物医学文献数据库,时限为建库至2022年2月。采用Cochrane 5.1.0手册进行质量评价,Stata 15.0进行频率学网状Meta分析。结果 共纳入44篇随机对照试验(足月儿29篇、早产儿15篇),涉及15种CAM(足月儿14种、早产儿7种),5206例新生儿(足月儿4337例、早产儿869例)。研究显示:对足月儿,12种CAM缓解疼痛的效果均优于常规干预(均P<0.05),母乳吮吸的汇总累积排序概率图下面积(surface under the cumulative, SUCRA)最大;对早产儿,5种CAM缓解疼痛的效果均优于常规干预(均P<0.05),音乐+非营养性吮吸(non-nutritive sucking, NNS)的SUCRA最大。结论 母乳吮吸缓解足月儿疼痛效果最佳,音乐+NNS缓解早产儿疼痛效果最佳;此外,音乐联合干预效果比音乐单独干预更佳;研究结果对临床护理人员干预新生儿疼痛具有指导意义。展开更多
目的:基于Meta分析方法,评价不同针刺方法配合中药熏洗治疗跟痛症的临床疗效。方法:检索中国知网、万方数据库、维普数据库、PubMed和Web of Science,纳入关于针刺配合中药熏洗治疗跟痛症的临床随机对照研究(观察组干预措施为针刺配合...目的:基于Meta分析方法,评价不同针刺方法配合中药熏洗治疗跟痛症的临床疗效。方法:检索中国知网、万方数据库、维普数据库、PubMed和Web of Science,纳入关于针刺配合中药熏洗治疗跟痛症的临床随机对照研究(观察组干预措施为针刺配合中药熏洗,不区分针具类型、选穴及中药类型;对照组为单纯使用针刺治疗或中药熏洗治疗或其他治疗方法),检索时间为建库至2022年3月。经Note express软件整理文献,使用Cochrane系统评价方法对纳入文献的质量进行评价,使用RevMan 5.3软件进行Meta分析。结果:共纳入随机对照试验研究13项,涉及患者1122例。经过Meta分析得出结果,观察组患者的总有效率明显高于对照组(OR=5.15,95%CI=3.32~8.00,P<0.00001),视觉模拟评分(VAS)明显低于对照组(SMD=-1.60,95%CI=-2.08~-1.13,P<0.00001),远期复发率明显低于对照组(OR=0.32,95%CI=0.18~0.59,P=0.0003),差异均有统计学意义。结论:相比单纯使用针刺或中药熏洗或其他疗法,不同针刺方法配合中药熏洗治疗跟痛症的临床疗效更确切,在提高总有效率、降低VAS评分和远期复发率方面有明显优势。但因纳入文献的质量不高,部分研究设计不够严谨,大多研究缺乏长期疗效的随访,对于远期复发率这一结局指标的支持证据不足,且纳入文献数量较少,因此,上述结论还有待于进一步研究验证。展开更多
目的探讨针刀松解(NKT)与体外冲击波(ESWT)治疗慢性跖筋膜炎型跟痛症(PHS-CPF)的临床疗效。方法收集2021年6月-2022年6月期间在南京医科大学金陵临床医学院骨科接受PHS-CPF治疗的48例患者,根据医患沟通结果和治疗方式分为NKT组(26例)和E...目的探讨针刀松解(NKT)与体外冲击波(ESWT)治疗慢性跖筋膜炎型跟痛症(PHS-CPF)的临床疗效。方法收集2021年6月-2022年6月期间在南京医科大学金陵临床医学院骨科接受PHS-CPF治疗的48例患者,根据医患沟通结果和治疗方式分为NKT组(26例)和ESWT组(22例),NKT组采用针刀松解治疗模式进行操作,ESWT组采用激痛点治疗模式进行操作。分别采用视觉模拟评分法(VAS)和压痛评分对2组治疗前及治疗后1周、1个月、3个月和6个月随访时的晨起足跟痛和足跟压痛进行评估。结果治疗后各随访时间节点,2组患者的晨起足跟痛和足跟压痛均较治疗前明显改善(P<0.05);2组治疗后1个月、3个月和6个月的晨起足跟痛和足跟压痛均低于治疗后1周(P<0.05);2组治疗后3个月和6个月的足跟压痛与治疗后1个月相比,差异不明显(P>0.05);NKT组治疗后3个月和6个月的晨起足跟痛均较治疗后1个月明显改善(1.88±0.71 vs 2.54±0.65,1.62±0.64 vs 2.54±0.65,P<0.05);与治疗后1个月相比,ESWT组治疗3个月后,晨起足跟痛无明显改善(P>0.05),而治疗6个月后,晨起足跟痛增加(4.32±0.78 vs 3.45±1.10,P<0.05)。治疗后1周时,NKT组的晨起足跟痛明显低于ESWT组(4.58±0.90 vs 5.27±0.98,P<0.05),而2组的足跟压痛差异不明显(P>0.05);治疗后1个月、3个月和6个月时,与ESWT组相比,NKT组在缓解晨起足跟痛(2.54±0.65 vs 3.45±1.10,1.88±0.71 vs 3.64±0.95,1.62±0.64 vs 4.32±0.78)和足跟压痛(0.58±0.58 vs 1.00±0.53,0.54±0.58 vs 1.09±0.61,0.73±0.53 vs 1.14±0.71)上更具优势(P<0.05)。结论NKT与ESWT治疗PHS-CPF的临床疗效确切,均能有效缓解晨起足跟痛和足跟压痛,并具有较好的维持治疗效果,但NKT的临床疗效更佳。展开更多
基金Supported by The Gusu Talents Project,No.GSWS2020069.
文摘BACKGROUND The accessory bones are common bone variations around the feet and ankles,which usually originate from nonunion of the secondary ossification center adjacent to the main bone mass,and most of them remain asymptomatic.Os subcalcis is an accessory bone at the plantar aspect of the calcaneus,which is located just posterior to the insertion of the plantar fascia.Focal bone formation at the calcaneal plantar pole with heel pain has rarely been reported.CASE SUMMARY A 55-year-old man presented to our clinic with left plantar heel pain and a progressive swelling for 8 years.X-ray,computer tomography and magnetic resonance imaging showed a large os subcalcison the plantar side of the calcaneus,located at the insertion of the plantar fascia.He underwent surgical excision of the lesion.Microscopically the bony trabeculae were intermingled with fat and covered with cartilage.CONCLUSION This is a rare case with accessory os subcalcis leading to heel pain.It highlights the awareness of os subcalcis and helps avoid future misdiagnosis of heel pain.
文摘BACKGROUND Heel pain is a common orthopaedic complaint,and if left untreated can be a source of chronic morbidity.Accurate diagnosis can be challenging,owing to the complex anatomy and multiple pain generators present in the foot.We aim to share our clinical experience managing an unusual case of chronic heel pain secondary to osteochondroma.CASE SUMMARY A 41-year-old obese male who works as a porter presented with a long-standing history of left plantar heel pain.He was assessed to have point tenderness over the plantar insertion of the calcaneus as well as a positive Silfverski?ld test.He was treated for plantar fasciitis and tight gastrocnemius but failed conservative therapies as well as surgical intervention.Magnetic resonance imaging revealed the presence of a pedunculated bony protrusion over the plantar aspect of the calcaneus.The decision was made for excision of the osteochondroma,and the patient has been pain-free since.CONCLUSION Osteochondromas are rarely symptomatic in skeletally mature patients.While most are benign with a very low risk of malignant transformation,surgical excision can yield excellent results and significant pain relief in symptomatic patients.
文摘Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger＇s heel, tennis heal, policeman＇s heel are used to describe it. Mechanical factors are the most common etiology of heel pain. Common causes of hell pain includes： Plantar Fasciitis, Heel Spur, Sever＇s Disease, Heel bump, Achilles Tendinopathy, Heel neuritis, Heel bursitis. The diagnosis is mostly based on clinical examination. Normally, the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis. Several therapies exist including rest, physical therapy, stretching, and change in footwear, arch supports, orthotics, night splints, anti-inflammatory agents, and surgery. Almost all patients respond to conservative nonsurgical therapy. Surgery is the last treatment option if all other treatments had failed. Rest, ice, massage, the use of correct exercise and complying with a doctor＇s advice all play important part in helping to recover from this hell pain condition, but getting good quality, suitable shoes with the appropriate amount of support for the whole foot is the most important.
基金supported by Jiaxing Hospital of Chinese Medicine
文摘Objective： To observe the clinical efficacy of Chinese herbal fumigation plus beating with mulberry stick in treating heel pain. Methods： Sixty patients with heel pain were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by Chinese herbal fumigation plus beating with mulberry stick, and the control group was by orally taking Diclofenac Sodium Sustained Release Tablets plus external use of She Xiong Zhen Tong Gao （Moschus Analgesic Plaster）. After one treatment course, the visual analogue scale （VAS） was used to observe the change of pain, and the clinical efficacies were also evaluated. Results： After intervention, the improvement of VAS score in the treatment group was more significant than that in the control group （P〈0.01）. The total effective rate of the treatment group was significantly higher than that of the control group （P〈0.01）. Conclusion： Chinese herbal fumigation plus beating with mulberry stick can produce a higher clinical efficacy than orally taking Diclofenac Sodium Sustained Release Tablets in treating heel pain.
文摘目的探讨活血通络汤外洗联合冲击波治疗跟痛症的临床效果。方法选取2020年1月—2022年12月武警第一机动总队医院收治的80例跟痛症患者为研究对象。按照治疗方法不同分为两组,各40例。对照组采用局部冲击波治疗,观察组在对照组治疗的基础上结合活血通络汤外洗治疗。比较两组治疗后每日跟痛持续时间、视觉模拟评分法(Visual Analog Scale,VAS)评分、Maryland足跟功能评分,统计两组治疗效果、并发症发生率,并随访1年,比较复发率。结果治疗后,观察组每日跟痛持续时间为(0.6±0.2)h,短于对照组的(5.6±1.8)h,差异有统计学意义(t=17.329,P<0.05)。治疗后,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后,两组Maryland足跟功能评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P均<0.05)。观察组治疗总有效率高于对照组,1年复发率低于对照组,差异有统计学意义(P均<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论跟痛症患者在使用冲击波治疗基础上联合应用活血通络汤外洗,可快速缓解患者足跟部疼痛,改善足部功能,提高治疗有效率,降低复发率,且不良反应少,安全性高。
文摘目的 评价不同补充和替代医学(complementary and alternative medicine, CAM)疗法对缓解新生儿足跟采血疼痛的应用效果。方法 计算机检索PubMed、Embase、Web of Science、Cochrane、CINAHL、中国知网、维普、万方、中国生物医学文献数据库,时限为建库至2022年2月。采用Cochrane 5.1.0手册进行质量评价,Stata 15.0进行频率学网状Meta分析。结果 共纳入44篇随机对照试验(足月儿29篇、早产儿15篇),涉及15种CAM(足月儿14种、早产儿7种),5206例新生儿(足月儿4337例、早产儿869例)。研究显示:对足月儿,12种CAM缓解疼痛的效果均优于常规干预(均P<0.05),母乳吮吸的汇总累积排序概率图下面积(surface under the cumulative, SUCRA)最大;对早产儿,5种CAM缓解疼痛的效果均优于常规干预(均P<0.05),音乐+非营养性吮吸(non-nutritive sucking, NNS)的SUCRA最大。结论 母乳吮吸缓解足月儿疼痛效果最佳,音乐+NNS缓解早产儿疼痛效果最佳;此外,音乐联合干预效果比音乐单独干预更佳;研究结果对临床护理人员干预新生儿疼痛具有指导意义。
文摘目的:基于Meta分析方法,评价不同针刺方法配合中药熏洗治疗跟痛症的临床疗效。方法:检索中国知网、万方数据库、维普数据库、PubMed和Web of Science,纳入关于针刺配合中药熏洗治疗跟痛症的临床随机对照研究(观察组干预措施为针刺配合中药熏洗,不区分针具类型、选穴及中药类型;对照组为单纯使用针刺治疗或中药熏洗治疗或其他治疗方法),检索时间为建库至2022年3月。经Note express软件整理文献,使用Cochrane系统评价方法对纳入文献的质量进行评价,使用RevMan 5.3软件进行Meta分析。结果:共纳入随机对照试验研究13项,涉及患者1122例。经过Meta分析得出结果,观察组患者的总有效率明显高于对照组(OR=5.15,95%CI=3.32~8.00,P<0.00001),视觉模拟评分(VAS)明显低于对照组(SMD=-1.60,95%CI=-2.08~-1.13,P<0.00001),远期复发率明显低于对照组(OR=0.32,95%CI=0.18~0.59,P=0.0003),差异均有统计学意义。结论:相比单纯使用针刺或中药熏洗或其他疗法,不同针刺方法配合中药熏洗治疗跟痛症的临床疗效更确切,在提高总有效率、降低VAS评分和远期复发率方面有明显优势。但因纳入文献的质量不高,部分研究设计不够严谨,大多研究缺乏长期疗效的随访,对于远期复发率这一结局指标的支持证据不足,且纳入文献数量较少,因此,上述结论还有待于进一步研究验证。
文摘目的探讨针刀松解(NKT)与体外冲击波(ESWT)治疗慢性跖筋膜炎型跟痛症(PHS-CPF)的临床疗效。方法收集2021年6月-2022年6月期间在南京医科大学金陵临床医学院骨科接受PHS-CPF治疗的48例患者,根据医患沟通结果和治疗方式分为NKT组(26例)和ESWT组(22例),NKT组采用针刀松解治疗模式进行操作,ESWT组采用激痛点治疗模式进行操作。分别采用视觉模拟评分法(VAS)和压痛评分对2组治疗前及治疗后1周、1个月、3个月和6个月随访时的晨起足跟痛和足跟压痛进行评估。结果治疗后各随访时间节点,2组患者的晨起足跟痛和足跟压痛均较治疗前明显改善(P<0.05);2组治疗后1个月、3个月和6个月的晨起足跟痛和足跟压痛均低于治疗后1周(P<0.05);2组治疗后3个月和6个月的足跟压痛与治疗后1个月相比,差异不明显(P>0.05);NKT组治疗后3个月和6个月的晨起足跟痛均较治疗后1个月明显改善(1.88±0.71 vs 2.54±0.65,1.62±0.64 vs 2.54±0.65,P<0.05);与治疗后1个月相比,ESWT组治疗3个月后,晨起足跟痛无明显改善(P>0.05),而治疗6个月后,晨起足跟痛增加(4.32±0.78 vs 3.45±1.10,P<0.05)。治疗后1周时,NKT组的晨起足跟痛明显低于ESWT组(4.58±0.90 vs 5.27±0.98,P<0.05),而2组的足跟压痛差异不明显(P>0.05);治疗后1个月、3个月和6个月时,与ESWT组相比,NKT组在缓解晨起足跟痛(2.54±0.65 vs 3.45±1.10,1.88±0.71 vs 3.64±0.95,1.62±0.64 vs 4.32±0.78)和足跟压痛(0.58±0.58 vs 1.00±0.53,0.54±0.58 vs 1.09±0.61,0.73±0.53 vs 1.14±0.71)上更具优势(P<0.05)。结论NKT与ESWT治疗PHS-CPF的临床疗效确切,均能有效缓解晨起足跟痛和足跟压痛,并具有较好的维持治疗效果,但NKT的临床疗效更佳。
