Chan Keith W, Ding Bryan C, Mroczek Kenneth J
Sutter Medical Group, Sacramento, California, USA.
Bull NYU Hosp Jt Dis. 2011;69(1):17-26.
Ankle sprain injuries are the most common injury sustained during sporting activities. Three-quarters of ankle injuries involve the lateral ligamentous complex, comprised of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The most common mechanism of injury in lateral ankle sprains occurs with forced plantar flexion and inversion of the ankle as the body's center of gravity rolls over the ankle. The ATFL followed by the CFL are the most commonly injured ligaments. Eighty percent of acute ankle sprains make a full recovery with conservative management, while 20% of acute ankle sprains develop mechanical or functional instability, resulting in chronic ankle instability. Treatment of acute ankle sprains generally can be successfully managed with a short period of immobilization that is followed by functional rehabilitation. Patients with chronic ankle instability who fail functional rehabilitation are best treated with a Brostrom-Gould anatomic repair or, in those patients with poor tissue quality or undergoing revision surgery, an anatomic reconstruction.
踝关节扭伤是体育活动中最常见的损伤。四分之三的踝关节损伤涉及外侧韧带复合体，该复合体由距腓前韧带（ATFL）、跟腓韧带（CFL）和距腓后韧带（PTFL）组成。外侧踝关节扭伤最常见的损伤机制是当身体重心越过踝关节时，踝关节被迫跖屈和内翻。最常受伤的韧带是距腓前韧带，其次是跟腓韧带。80%的急性踝关节扭伤通过保守治疗可完全恢复，而20%的急性踝关节扭伤会出现机械性或功能性不稳定，导致慢性踝关节不稳定。急性踝关节扭伤的治疗通常通过短期固定，随后进行功能康复，一般可成功处理。慢性踝关节不稳定且功能康复失败的患者，最好采用Brostrom-Gould解剖修复术治疗；对于组织质量差或接受翻修手术的患者，则采用解剖重建术治疗。
