CAJ | 학술논문

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。
목적탐토제삼지저총신경잡압종합정적발병궤리、진단화치료。방법대34례제삼지저총신경잡압종합정환자수선보수치료,포괄천대척골점연혜,내복중약,중약수전려액직류통전도입,병환국부류고순격소봉폐등。보수치료무효15례급복발3례작척저심횡인대절단화신경송해술,5례가작신경류절제술。결과 34례수선보수치료,19례유효,기중복발6례,무효15례。수술치료18례미견복발。결론지배신시험화전족횡향가압시험대림상진단흔유개치。보수치료재조기통상시유효적。보수치료실패,칙응작척저심횡인대절단、신경송해술화신경류절제술,수술효과시만의적。
Objective To study the pathogenesis,diagnosis and treatment of the compression syndrome of the third common plantar digital nerves.Methods Conservative methods were at first used for all the 34 cases of this disease.Treatment methods includes:wearing shoes with soft bottom and metatarsal pad;the administration of Chinese herbs;the application of direct current iontherapy by filtering Chinese herbs and performing local injection therapy with steroid at the tenderness points.15 patients with no effect following conservative methods and other 3 recurrent cases were treated with section of deep transverse metatarsal ligament and relaxing the nerves compression.Of the 18 cases,5 had additional to excision of the neuroma.Results Of the 34 cases treated with conservative methods,19 had effective results,of which 6 cases recurred,and 15 cases had no effect.18 cases treated with operation had no recurrence.Conclusion Toe extending test and forefoot transversely compressing test provide a valuable basis for diagnosis.Conservative treatment are usually effective in earlier phase.If conservative treatment is not effective,the transverse metatarsal ligament should be sectioned,nerves should be relaxed and the neuroma must be excised.The results of operative treatment are satisfactory.