Erasmus MC University Medical Center Rotterdam, Department of General Practice, The Netherlands.
Erasmus MC University Medical Center Rotterdam, Department of Radiology, The Netherlands.
J Sci Med Sport. 2019 Aug;22(8):866-870. doi: 10.1016/j.jsams.2019.02.009. Epub 2019 Mar 6.
To examine clinical and radiological characteristics of participants with an ankle sprain in general practice, classified into subgroups of a previously described chronic ankle instability (CAI) model.
Cross-sectional study.
206 participants, who visited their general practitioner with a lateral ankle sprain 6-12 months before inclusion, completed a questionnaire, physical examination, radiography and magnetic resonance imaging. They were classified into three subgroups of the previously described CAI-model: mechanical instability (MI), perceived instability (PI) and recurrent sprains (RS). Regression analyses were applied to evaluate differences in subgroup characteristics.
A total of 192 participants were eligible to be classified into the model. Of these participants, 153 participants were classified into the subgroups and 39 could not be classified. With overlap between the subgroups and patients falling into more than one subgroup, 59 were classified having MI, 145 having PI and 30 having RS. Participants with RS and PI were more often sports participants (OR 6.83;95%CI 1.35-34.56 and OR 4.44;95%CI1.06-18.63 respectively) than participants without RS and PI. Participants with MI more often had a tenderness on palpation of the anterior talofibular ligament (OR 4.09;95%CI 1.91-8.72) and a KL-score≥1 in the talonavicular joint on X-ray (OR 2.24;95%CI 1.09-4.58), compared to participants without MI.
Sports participation, tenderness on palpation of the anterior talofibular ligament and early signs of osteoarthritis were variables that discriminated between subgroups of CAI. However, further research is mandatory in order to examine the usefulness of the CAI model in relation to prognosis and suitable intervention.
研究普通门诊踝关节扭伤患者的临床和影像学特征，将其分为先前描述的慢性踝关节不稳定（CAI）模型的亚组。
横断面研究。
206 名参与者在纳入前 6-12 个月因外侧踝关节扭伤就诊于他们的全科医生，完成了一份问卷、体格检查、X 线摄影和磁共振成像。他们被分为先前描述的 CAI 模型的三个亚组：机械不稳定（MI）、感觉不稳定（PI）和复发性扭伤（RS）。回归分析用于评估亚组特征的差异。
共有 192 名参与者符合纳入模型的标准。其中，153 名参与者被分类为亚组，39 名参与者无法分类。由于亚组之间存在重叠，并且患者可能同时属于多个亚组，因此 59 名参与者被归类为 MI，145 名参与者被归类为 PI，30 名参与者被归类为 RS。RS 和 PI 的参与者更经常是运动参与者（OR6.83；95%CI1.35-34.56 和 OR4.44；95%CI1.06-18.63），而没有 RS 和 PI 的参与者。MI 参与者的前距腓韧带触诊时更常出现压痛（OR4.09；95%CI1.91-8.72）和 X 射线跗骨间关节 KL 评分≥1（OR2.24；95%CI1.09-4.58），与没有 MI 的参与者相比。
运动参与、前距腓韧带触诊时的压痛和早期骨关节炎迹象是区分 CAI 亚组的变量。然而，为了检验 CAI 模型在预后和合适干预方面的有用性，还需要进一步的研究。
