RU2206285C2 - Method for treating heel calcar due to surgical laser - Google Patents

Abstract

FIELD: medicine, orthopedics, traumatology. SUBSTANCE: local anesthesia should be carried out. Perforation of calcar, pericalcar bursa and partially sole aponeurosis at area of its joining to calcar is performed due to surgical laser through a needle for intraosseous anesthesia. EFFECT: decreased traumaticity, increased efficiency of therapy.

Description

 The invention relates to medicine and can be used to eliminate the pathological symptom complex that occurs with heel spur.

 Ossifying periostitis (calcaneal spur) in the area of attachment of the plantar aponeurosis to the calcaneal tuber is more common in middle-aged people suffering from longitudinal flatfoot, and is manifested by pain along the medial-plantar surface of the calcaneal tuber due to inflammation of the soft tissues surrounding the spur, injured by bone exostosis (loading on the bone with exostosis) paranasal bag, tissues of the plantar aponeurosis, fascia, periosteum, etc.) [1].

 The analogues of our proposed method are traditional methods of treating heel spurs - limiting physical activity, physiotherapy, and heat. With the ineffectiveness of these types of treatment, X-ray therapy and local administration of steroids are prescribed [1, 2]. However, against the background of such therapy, the pain syndrome can persist for many months, and sometimes years, which sharply worsens the quality of life of patients.

 The prototype of the technique proposed by the authors is a closed compression of the heel spur [3], when under intravenous anesthesia a closed compression of the heel spur is performed with three to four blows of a hammer on a metal nozzle (diameter at the end of 2 cm), which is firmly pressed to the skin at a painful point in position maximum plantar flexion and extension of the fingers. After manipulation, a fracture of the spur is detected on the radiograph, more often at the acute end of it. However, such an intervention is traumatic. Due to the fact that the manipulation is closed, softening of the soft tissues located between the spur and the metal nozzle is softened, as well as damage to the bone structure of the spur (fracture), which increases the duration of rehabilitation treatment.

 Our proposed method is less traumatic because the manipulation is performed under local anesthesia, without injuring the soft tissues, due to the fact that the puncture-perforating and thermal effects are directly on the pathological focus within 10 seconds, through the light guide passing inside the needle. The focus of inflammation is palpation, at the site of greatest pain in the corresponding calcaneal spur.

 The course of treatment consists of three manipulations (one per week). After each manipulation, the limb is immobilized by a removable plaster cast in the position of plantar flexion. Patients during the treatment period (3 weeks) use crutches.

 The thermal effect on the tissues surrounding the spur causes their destruction and aseptic inflammation, the outcome of which is obliteration of the bursa and scar-sclerotic degeneration of the tissues surrounding the spur. In addition, during thermal destruction sensitive nerve endings die, which leads to the disappearance of pain in the spur immediately after manipulation. Anesthetics are therefore not prescribed.

 According to this technique, 14 patients were treated. The observation period is 1.5 years. No disease recurrence was observed during the entire observation period.

 Patient I., 49 years old, was admitted to RosNIITiO them. R.R. Damaged 08.12.00 with a diagnosis of Calcaneal spur on the left. According to the above scheme, perforation of the near-spur structures was performed with a surgical laser. During treatment, pain cider was stopped, the patient was discharged to work in satisfactory condition.

 A method for treating calcaneal spurs with a surgical laser, including local anesthesia for relief of pain at first, then perforation through a needle for intraosseous anesthesia with a surgical laser for a spur, paranasal bursa and partially plantar aponeurosis in the area of its attachment to the spur, allows to reduce trauma and ensure treatment effectiveness.

Sources of information
1. Guidelines for orthopedics and traumatology by the editors N.P. Novachenko. M .: Medicine. - 1968.

 2. Cherkess-3ade D.I., Kamenev Yu.F. Foot Surgery, M .: Medicine. - 1995 .-- S. 223-225.

 3. Shaposhnikov V.I. Materials of the 6th congress of orthopedic traumatologists of the CIS, Yaroslavl - 1993. - P. 418.

Claims (1)

 A method of treating a heel spur with a surgical laser, characterized in that for relief of the pain syndrome, after local anesthesia, the spur, paranasal bursa and partially plantar aponeurosis are perforated with a surgical laser through the needle for intraosseous anesthesia in the area of its attachment to the spur.