Panagiotakis Emmanouil, Mok Kam-Ming, Fong Daniel Tik-Pui, Bull Anthony M J
Department of Bioengineering, Imperial College, United Kingdom.
Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
J Sci Med Sport. 2017 Dec;20(12):1057-1061. doi: 10.1016/j.jsams.2017.05.006. Epub 2017 May 25.
Ankle sprains due to landing on an opponent's foot are common in basketball. There is no analysis to date that provides a quantification of this injury mechanism. The aim of this study was to quantify the kinematics of this specific injury mechanism and relate this to lateral ankle ligament biomechanics.
Case series.
The model-based image-matching technique was used to quantify calcaneo-fibular-talar kinematics during four ankle inversion sprain injury incidents in televised NBA basketball games. The four incidents follow the same injury pattern in which the players of interest step onto an opponent's foot with significant inversion and a diagnosed ankle injury. A geometric analysis was performed to calculate the in vivo ligament strains and strain rates for the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL).
Despite the controlled selection of cases, the results show that there are two distinct injury mechanisms: sudden inversion and internal rotation with low levels of plantarflexion; and a similar mechanism without internal rotation. The first of these mechanisms results in high ATFL and CFL strains, whereas the second of these strains the CFL in isolation.
The injury mechanism combined with measures of the ligament injury in terms of percentage of strain to failure correlate directly with the severity of the injury quantified by return-to-sport. The opportunity to control excessive internal rotation through proprioceptive training and/or prophylactic footwear or bracing could be utilised to reduce the severity of common ankle injuries in basketball.
在篮球运动中，因踩到对手的脚而导致的踝关节扭伤很常见。迄今为止，尚无分析对这种损伤机制进行量化。本研究的目的是量化这种特定损伤机制的运动学，并将其与外侧踝关节韧带生物力学联系起来。
病例系列。
采用基于模型的图像匹配技术，对电视转播的NBA篮球比赛中4起踝关节内翻扭伤损伤事件中的跟腓距运动学进行量化。这4起事件遵循相同的损伤模式，即相关球员以明显的内翻动作踩到对手的脚上，并被诊断为踝关节损伤。进行几何分析以计算距腓前韧带（ATFL）和跟腓韧带（CFL）的体内韧带应变和应变率。
尽管对病例进行了严格挑选，但结果表明存在两种不同的损伤机制：突然内翻并伴有低水平跖屈的内旋；以及一种不伴有内旋的类似机制。其中第一种机制会导致ATFL和CFL产生高应变，而第二种机制仅使CFL产生应变。
损伤机制与韧带损伤程度（以应变至失效的百分比衡量）相结合，与通过恢复运动来量化的损伤严重程度直接相关。通过本体感觉训练和/或预防性鞋类或支具来控制过度内旋的机会，可用于降低篮球运动中常见踝关节损伤的严重程度。
