Renstrom PA
McClure Musculoskeletal Research Center, University of Vermont, Department of Orthopaedics and Rehabilitation, Burlington.
J Am Acad Orthop Surg. 1994 Oct;2(5):270-280.
Chronic discomfort sufficient to limit activity may affect 20% to 40% of patients after an ankle sprain. These patients complain of vague and diffuse pain, most often localized to the lateral and/or anterolateral aspect of the ankle. They may also complain of a giving-way sensation, swelling, stiffness, and locking and crepitation. Examination may show tenderness, swelling, and reduced range of motion, especially in dorsiflexion. Ankle instability is sometimes demonstrable. Severe cases exhibit discoloration, glossy skin, and temperature changes suggestive of reflex sympathetic dystrophy. Incomplete rehabilitation is the most common cause of chronic pain. Other common problems are intra-articular lesions (e.g., osteochondral and meniscoid lesions), chronic instability, undetected syndesmotic or deltoid sprains, chronic tendon degeneration, stress fractures, and, in rare cases, congenital lesions and tumors. Reflex sympathetic dystrophy occurs occasionally, even after minor trauma. With correct diagnosis and appropriate treatment, it is often possible to restore acceptable ankle function
踝关节扭伤后，足以限制活动的慢性不适可能影响20%至40%的患者。这些患者主诉疼痛模糊且弥漫，最常局限于踝关节的外侧和/或前外侧。他们还可能主诉有打软腿的感觉、肿胀、僵硬、交锁和弹响。体格检查可能显示压痛、肿胀和活动范围减小，尤其是背屈时。踝关节不稳有时可被证实。严重病例表现为变色、皮肤发亮和温度变化，提示反射性交感神经营养不良。康复不完全是慢性疼痛最常见的原因。其他常见问题包括关节内病变（如骨软骨损伤和类半月板损伤）、慢性不稳、未被发现的下胫腓联合或三角韧带扭伤、慢性肌腱退变、应力性骨折，以及罕见的先天性病变和肿瘤。即使是轻微创伤后，反射性交感神经营养不良也偶尔会发生。通过正确的诊断和适当的治疗，通常有可能恢复可接受的踝关节功能。
