Topuk Ağrısında Tedavi Noktalarının Lokalizasyonu için Bir Kılavuz

Abstract

Amaç: Bu çalışma, plantar fasiit ve Baxter nöropatisi tedavisinde enjeksiyon ve nöroablasyon uygulamaları için üç boyutlu yeni bir yöntemle kalkaneal bölgedeki hedef noktayı belirlemeyi ve daha doğru, kişiselleştirilmiş bir lokalizasyon yöntemi sunmayı amaçlamaktadır. Gereç ve Yöntemler: Ayak patolojisi şüphesiyle MR yapılan 65 hastanın verileri retrospektif olarak incelendi. Baxter siniri ile plantar fasyanın yapışma noktası hedeflendi. Hedef bölgenin deri yüzeyine olan medial (yatay), inferior (longitudinal) ve posterior (sagital) mesafeleri üç boyutlu ölçümle kaydedildi; bu ölçümler cinsiyet ve ayakkabı numarası ile korele edildi. İstatistiksel analizlerde tanımlayıcı yöntemler, normal dağılım değerlendirmesi ve uygun parametrik/non-parametrik testler kullanıldı (p<0,05 anlamlı kabul edildi). Bulgular: Medial, inferior ve posterior mesafelerin ortalamaları sırasıyla 24,26 ± 4,36 mm, 25,97 ± 3,62 mm ve 42,40 ± 4,60 mm olarak bulundu. Inferior ve posterior mesafeler kadınlarda erkeklere göre anlamlı olarak daha kısaydı (p < 0,001). Ayakkabı numarası arttıkça inferior (r = 0,407; p < 0,01) ve posterior (r = 0,653; p < 0,001) mesafelerde anlamlı artış gözlendi. Sonuç: Bu çalışma, plantar fasiit ve Baxter nöropatisi tedavisinde anatomik lokalizasyonu iyileştirmek için yenilikçi bir üç boyutlu yöntem sunmaktadır. Cinsiyet ve ayakkabı numarasının mesafe ölçümlerini etkilediği belirlenmiş olup, geliştirilen yaklaşım daha doğru ve kişiselleştirilmiş tedavi stratejilerine katkı sağlayacaktır. Ayrıca, gelecekte yapılacak prospektif ve geniş ölçekli çalışmalar yöntemin klinik etkinliğini doğrulamaya katkı sağlayacaktır.

Keywords

• Plantar fasiit
• Mononöropatiler
• Radyofrekans Ablasyonu
• Enjeksiyonlar

A Guideline for the Localization of Treatment Points in Heel Pain

Abstract

Aim: To determine the target point in the calcaneal region for injection and neuroablation applications in the treatment of plantar fasciitis and Baxter neuropathy using a newly developed three-dimensional approach, providing a more accurate and personalized localization method. Material and Methods: Data from 65 patients who underwent MRI for suspected foot pathology were retrospectively analyzed. The Baxter nerve and the adhesion point of the plantar fascia were identified. Three-dimensional measurements of the medial (horizontal), inferior (longitudinal), and posterior (sagittal) distances from this target area to the skin surface were performed. Correlations between these distances and patient gender as well as shoe size were evaluated. Statistical analyses included descriptive methods, normality testing, and appropriate parametric/non-parametric tests (p<0.05 was considered statistically significant). Results: The mean medial, inferior, and posterior distances were 24.26 ± 4.36 mm, 25.97 ± 3.62 mm, and 42.40 ± 4.60 mm, respectively. Inferior and posterior distances were significantly shorter in women than in men (p < 0.001). A positive correlation was observed between shoe size and both inferior (r = 0.407, p < 0.01) and posterior (r = 0.653, p < 0.001) distances. Conclusion: This study presents a novel three-dimensional method to enhance anatomical localization for the treatment of plantar fasciitis and Baxter neuropathy. Findings demonstrate that gender and shoe size significantly influence distance measurements, supporting the use of this approach to achieve more precise and personalized therapeutic strategies. Furthermore, future prospective and large-scale studies will contribute to confirming its clinical effectiveness.

Keywords

• Plantar faciitis
• Mononeuropathies
• Radiofrequency Ablation
• Injections

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