Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo, Rome, Italy,
Curr Rev Musculoskelet Med. 2013 Dec;6(4):313-9. doi: 10.1007/s12178-013-9183-x.
Ankle syndesmosis injuries are relatively frequent in sports, especially skiing, ice hockey, and soccer, accounting for 1 %-18 % of all ankle sprains. The evolution is unpredictable: When missed, repeated episodes of ankle instability may predispose to early degenerative changes, and frank osteoarthritis may ensue. Diagnosis is clinical and radiological, but arthroscopy may provide a definitive response, allowing one to address secondary injuries to bone and cartilage. Obvious diastasis needs to be reduced and fixed operatively, whereas less severe injuries are controversial. Nonoperative treatment may be beneficial, but it entails long rehabilitation. In professional athletes, more aggressive surgical treatment is warranted.
踝关节联合损伤在运动中较为常见，尤其是滑雪、冰球和足球，占所有踝关节扭伤的 1%-18%。其演变是不可预测的：如果漏诊，反复出现的踝关节不稳定可能导致早期退行性改变，随后可能出现明显的骨关节炎。诊断主要依靠临床和影像学检查，但关节镜检查可提供明确的诊断，有助于处理骨和软骨的继发性损伤。明显的分离需要手术复位和固定，而较轻的损伤存在争议。非手术治疗可能有益，但需要较长的康复期。对于职业运动员，更积极的手术治疗是必要的。
