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踝关节韧带扭伤和撕裂的处理:当前观点

Managing ankle ligament sprains and tears: current opinion.

作者信息

McGovern Ryan P, Martin RobRoy L

机构信息

Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.

Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA; Centers for Sports Medicine - University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Open Access J Sports Med. 2016 Mar 2;7:33-42. doi: 10.2147/OAJSM.S72334. eCollection 2016.

Abstract

The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected structures should be obtained through history and objective assessment. From this information, an individualized evidence-based intervention plan can be developed to enable recovery while decreasing the risk of reinjury. An appropriate evaluation is needed not only to determine the correct diagnosis but also to allow for grading and determining the prognosis of the injury in those with an acute lateral ankle sprain. Examination should include an assessment of impairments as well as a measure of activity and participation. Evidence-based interventions for those with an acute lateral ankle sprain should include weight bearing with bracing, manual therapy, progressive therapeutic exercises, and cryotherapy. For those with chronic ankle instability (CAI), interventions should include manual therapy and a comprehensive rehabilitation program. It is essential to understand the normal clinical course for athletes who sustain a lateral ankle sprain as well as risk factors for an acute injury and CAI. Risk factors for both an acute lateral ankle sprain and CAI include not using an external support and not participating in an appropriate exercise program. Incorporating the latest evidence-based rehabilitation techniques provides the best course of treatment for athletes with an acute ankle sprain or CAI.

摘要

本文旨在对与外侧踝关节韧带扭伤处理相关的病理解剖特征、鉴别诊断、客观评估、干预措施及临床病程进行综述。应通过病史和客观评估来正确诊断并识别受影响的结构。基于这些信息,可制定个体化的循证干预计划,以促进康复并降低再次受伤的风险。对于急性外侧踝关节扭伤患者,不仅需要进行恰当评估以确定正确诊断,还需对损伤进行分级并判断预后。检查应包括对功能障碍的评估以及对活动和参与度的测量。急性外侧踝关节扭伤患者的循证干预措施应包括负重支具固定、手法治疗、渐进性治疗性锻炼及冷冻疗法。对于慢性踝关节不稳(CAI)患者,干预措施应包括手法治疗及全面的康复计划。了解外侧踝关节扭伤运动员的正常临床病程以及急性损伤和CAI的危险因素至关重要。急性外侧踝关节扭伤和CAI的危险因素均包括未使用外部支撑及未参与适当的锻炼计划。采用最新的循证康复技术可为急性踝关节扭伤或CAI运动员提供最佳治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30f/4780668/0deb993df471/oajsm-7-033Fig1.jpg

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