Australian Institute of Sport, Bruce, Australian Capital Territory, Australia.
Clin J Sport Med. 2011 Nov;21(6):524-9. doi: 10.1097/JSM.0b013e318234be7d.
To review the research conclusions relating to clinical aspects of syndesmosis, the incidence and prognosis of syndesmosis injuries, and the effectiveness of the history and clinical examination to reliably diagnose ankle syndesmosis injury.
Google Scholar search: Syndesmosis paired with incidence, prognosis, history, and examination in turn. There was no time limit for the search. Articles were selected by reading titles, abstracts, and the full article, if indicated, seeking original articles determining these clinical aspects of syndesmosis injuries. Further articles were derived from the references of the primary articles.
The prognosis for isolated syndesmosis injuries, including the time to functional recovery, is unknown. The incidence of acute syndesmosis injury in moderate to severe ankle injuries requiring imaging is of the order of 5%. Historical features and special clinical tests of syndesmosis injury have not been proven reliable by clinical studies using evidence-based diagnostic criteria. Acute local tenderness of the anterior inferior tibiofibular ligament will indicate significant syndesmosis injury in only approximately half of nonspecific ankle injuries.
There is limited, evidence-based, standard, published literature from which to draw conclusions regarding the validity or reliability of various clinical special tests for syndesmosis injury. Literature assessing the incidence, prognosis, and clinical features is generally not based on definitively confirmed syndesmosis injuries, which is a critical aspect of evidence-based medicine before valid conclusions can be drawn.
回顾与踝关节联合损伤的临床方面、联合损伤的发生率和预后，以及病史和临床检查可靠诊断踝关节联合损伤相关的研究结论。
在 Google Scholar 上依次搜索“联合，发生率，预后，病史和检查”。没有时间限制。通过阅读标题、摘要和全文（如果需要）选择文章，寻找确定这些踝关节联合损伤临床方面的原始文章。从主要文章的参考文献中衍生出更多的文章。
单纯联合损伤的预后，包括功能恢复的时间，尚不清楚。在需要影像学检查的中重度踝关节损伤中，急性联合损伤的发生率约为 5%。使用基于证据的诊断标准的临床研究并未证明病史特征和联合损伤的特殊临床检查具有可靠性。急性下胫腓前韧带局部压痛仅能在大约一半的非特异性踝关节损伤中提示存在明显的联合损伤。
对于各种用于诊断踝关节联合损伤的特殊临床检查的有效性或可靠性，仅有有限的基于证据的标准已发表文献可供参考。评估发生率、预后和临床特征的文献通常不是基于明确证实的联合损伤，这是在得出有效结论之前基于循证医学的一个关键方面。
