Uys Hendrik D, Rijke Arie M
Department of Orthopaedics, Nelson R Mandela Medical School, University of Natal, Congella, South Africa.
Am J Sports Med. 2002 Nov-Dec;30(6):816-22. doi: 10.1177/03635465020300061101.
Information concerning the clinical association between syndesmosis injury and grade of lateral ankle ligament damage would aid in the diagnosis and treatment of ankle sprains.
Evaluation of lateral ligament injury in terms of percentage tear of both the anterior talofibular and calcaneofibular ligaments can provide information on the extent of syndesmotic involvement.
Prospective cohort study.
Twenty-five patients volunteered to have magnetic resonance imaging examinations performed and 21 volunteered to undergo graded stress radiographs. Talar tilt angles were measured from radiographs taken with 0, 6, 9, 12, and 15 daN of force applied medially just above the ankle joint, and the percentage of ligament tear and grade of injury were determined. Scans were obtained with the foot in neutral and plantar flexion to image the anterior talofibular and calcaneofibular ligaments.
Grades of lateral ligament injury determined by magnetic resonance imaging and graded stress radiography were the same. The extent of syndesmotic injury could be assessed for all patients.
Intact tibiofibular ligaments were found equally frequently among patients with normal or any grade of lateral ligament damage, but the more severe injuries to the syndesmotic ligaments were associated with normal or minimally traumatized lateral ligaments. The inverse correlation can be explained on the basis of the difference between the mechanisms that precipitate these injuries.
关于下胫腓联合损伤与外侧踝关节韧带损伤程度之间临床关联的信息，将有助于踝关节扭伤的诊断和治疗。
以前距腓韧带和跟腓韧带撕裂百分比来评估外侧韧带损伤，能够提供有关下胫腓联合受累程度的信息。
前瞻性队列研究。
25名患者自愿接受磁共振成像检查，21名患者自愿接受分级应力X线片检查。在内侧踝关节上方分别施加0、6、9、12和15达因的力拍摄X线片，测量距骨倾斜角，并确定韧带撕裂百分比和损伤程度。足部处于中立位和跖屈位时进行扫描，以成像前距腓韧带和跟腓韧带。
通过磁共振成像和分级应力X线片确定的外侧韧带损伤程度相同。所有患者的下胫腓联合损伤程度均可评估。
在外侧韧带损伤程度正常或任何等级的患者中，胫腓韧带完整的情况同样常见，但下胫腓联合韧带更严重的损伤与正常或轻度损伤的外侧韧带相关。这种负相关可以根据导致这些损伤的机制差异来解释。
