Smith Andrew H, Bach Bernard R
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA.
Phys Sportsmed. 2004 Dec;32(12):39-43. doi: 10.3810/psm.2004.12.680.
High ankle sprains, or syndesmotic injuries, are a distinct entity from the more common inversion ankle sprain. Dorsiflexion of the ankle, external rotation of the leg, or a combination of both can disrupt the syndesmotic ligament complex, including the anterior and posterior tibiofibular ligaments. Diagnostic maneuvers, such as the squeeze test and the external rotation test, plus radiographic findings help make the diagnosis. Less severe sprains can be treated nonoperatively with protected weight bearing, but grade 3 sprains require surgical anatomic reduction of the syndesmotic joint. If misdiagnosed or managed incorrectly, syndesmotic injuries can lead to unfavorable late sequelae. Clinicians should set realistic expectations for a long recovery period and slow return to sports.
高位踝关节扭伤，即下胫腓联合损伤，与更常见的内翻型踝关节扭伤是不同的病症。踝关节背屈、小腿外旋或两者结合，都可能破坏下胫腓联合韧带复合体，包括胫腓前韧带和胫腓后韧带。挤压试验和外旋试验等诊断手法，以及影像学检查结果有助于做出诊断。较轻的扭伤可通过保护下负重进行非手术治疗，但3级扭伤需要对下胫腓联合关节进行手术解剖复位。如果误诊或处理不当，下胫腓联合损伤可能导致不良的晚期后遗症。临床医生应对较长的恢复期和缓慢的运动恢复设定现实的预期。
