Osborne Michael D, Rizzo Thomas D
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida, USA.
Sports Med. 2003;33(15):1145-50. doi: 10.2165/00007256-200333150-00005.
The frequent nature of ankle sprains and persistent disability that often ensues has lead to considerable medical costs. As prevention of disease and injury becomes an increasingly important part of the practice of medicine today, we strive to understand and identify interventions that optimally reduce the frequency of ankle sprain and re-injury. In doing so, considerable morbidity and unnecessary medical expenditures may potentially be averted. The prophylactic use of ankle braces is fairly common. Recent critical evaluation of their effectiveness supports their use for at least 6 months following injury in athletes who have sustained a moderate or severe sprain; however, their role in primary prevention of ankle sprain is less evident. Functional ankle rehabilitation is the mainstay of acute ankle sprain treatment and in recent reviews has been deemed preferable to immobilisation or early surgery for initial treatment of acutely injured ankles. Furthermore, certain components of ankle rehabilitation, such as proprioceptive exercises, have been found to protect the joint from re-injury. Multifaceted ankle sprain prevention programmes that incorporate a variety of strategies for injury reduction are also effective in sprain prevention, although the relative importance of each component of such programmes warrants further investigation. Surgery for ankle sprain is principally reserved for patients who fail a comprehensive non-operative treatment programme and can be highly successful in treating chronic functional instability. This paper examines the current literature regarding common ankle sprain prevention strategies and provides a review of appropriate treatment schemes.
踝关节扭伤频繁发生且常常随之导致持续的功能障碍，这已造成了相当高的医疗费用。随着疾病和损伤预防在当今医学实践中变得愈发重要，我们努力去理解和确定能最有效地降低踝关节扭伤和再次受伤频率的干预措施。这样做有可能避免相当多的发病率和不必要的医疗支出。预防性使用踝关节支具相当普遍。近期对其有效性的严格评估支持在中度或重度扭伤的运动员受伤后至少使用6个月；然而，它们在踝关节扭伤一级预防中的作用尚不明显。功能性踝关节康复是急性踝关节扭伤治疗的主要方法，并且在最近的综述中被认为对于急性受伤踝关节的初始治疗而言优于固定或早期手术。此外，已发现踝关节康复的某些组成部分，如本体感觉训练，可保护关节避免再次受伤。纳入多种减少损伤策略的多方面踝关节扭伤预防方案在扭伤预防方面也很有效，尽管此类方案各组成部分的相对重要性有待进一步研究。踝关节扭伤手术主要适用于未能通过全面非手术治疗方案的患者，并且在治疗慢性功能不稳方面可能非常成功。本文审视了有关常见踝关节扭伤预防策略的当前文献，并对适当的治疗方案进行了综述。
