第三趾底总神经卡压综合征.PDFVIP

中国骨伤 2001 年 3 月第 14 卷第 3 期 China J Orthop T rauma, March 2001, Vol. 14, No. 3 % 141 % 第三趾底总神经卡压综合征 李明祚 崔明 吴林康 ( 上海日晖医院, 上海 200032) 摘要 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, 手术效果是满意的。 关键词 神经压迫综合征 足疾病 神经外科手术 中草药 The compression syndrome of the third common plantar digital nerves L I M ingz uo , C UI M ing , W U Lin kang . Rihui H osp ital ( Shanghai, 200032) Abstract Objective T o study the patho genesis, diag nosis and treatment of the co mpression syndrome of the third common plantar digital nerves. Methods Conservative methods w ere at first used for all the 34 cases of this disease. T reatment methods includes: wearing shoes wit h soft bo ttom and metatarsal pad; the ad ministratio n of Chinese herbs; the application of direct current io ntherapy by filtering Chinese herbs and per forming local injection therapy with steroid at the tenderness points. 15 patients with no effect follow ing con servativ e methods and other 3 recurrent cases were treated w ith section of deep transverse metatarsal lig ament and relax ing t he nerves co mpression. O f the 18 cases, 5 had additional to excisio n of the neuroma. Results Of t he 34 cases treated w ith conservative methods, 19 had effective results, of which 6 cases recurred, and 15 cases had no effect . 18 cases treated w ith operat ion had no recurrence. Conclusion T oe extending test and forefoo t t ransversely compressing test provide a va