Choi Wan Sun, Cho Jae Ho, Lee Doo Hyung, Chung Jun Young, Lim Su Min, Park Young Uk
Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggi-do, Republic of Korea.
Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggi-do, Republic of Korea.
J Orthop Sci. 2020 Mar;25(2):303-309. doi: 10.1016/j.jos.2019.04.012. Epub 2019 Jun 7.
Ankle sprains are one of the most common musculoskeletal injuries. To guide management decisions, a clear insight into the relevant subgroups of patients with a potentially better or worse prognosis is important. This study aimed to evaluate injury severity, using ultrasonography (US), as a prognostic factor of acute ankle sprain and other possible factors including age, sex, body mass index (BMI), level of job activity, and level of sports activity.
We retrospectively reviewed 28 patients with acute ankle sprain who reported at initial examination with an acutely twisted ankle. All patients had received a standard physical examination, radiography and standard ultrasound, to diagnose specific ligament injuries and their ankle sprain had been treated using standard conservative management. Various data including age, sex, BMI, level of sports activity, level of daily job activity, and final functional score (Foot and Ankle Outcome Scores, FAOS) were obtained. Mean comparison and correlations were used to assess risk factors. Risk factors associated with functional outcomes were evaluated using a multiple linear regression test.
At final follow-up as 1 year after injury, FAOS differed significantly for injury severity, age, and BMI. There were no significant differences in sex, job activity, and exercise levels. The factor most affecting FAOS for both pain (FAOS-Pain) and symptoms (FAOS-Sx) was the number of completely torn ligaments. Age was the most important factor affecting the FAOS-Daily Living Activity (ADL). BMI was the most important factor for sports activity level (FAOS-Sports). Age and the number of completely torn ligaments were both important to FAOS-Sports and quality of life (FAOS-QOL).
The severity of injury, defined using US, was a prognostic factor for long-term outcome following acute ankle sprain. Therefore, US imaging of acute ankle ligament injury may be important to predict prognosis of acute ankle sprain.
踝关节扭伤是最常见的肌肉骨骼损伤之一。为指导管理决策，深入了解预后可能较好或较差的相关患者亚组很重要。本研究旨在评估使用超声（US）测量的损伤严重程度作为急性踝关节扭伤的预后因素，以及其他可能的因素，包括年龄、性别、体重指数（BMI）、工作活动水平和体育活动水平。
我们回顾性分析了28例急性踝关节扭伤患者，这些患者在初次检查时报告有急性脚踝扭伤。所有患者均接受了标准体格检查、X线摄影和标准超声检查，以诊断特定韧带损伤，其踝关节扭伤采用标准保守治疗。获取了包括年龄、性别、BMI、体育活动水平、日常工作活动水平和最终功能评分（足踝结果评分，FAOS）等各种数据。采用均值比较和相关性分析来评估危险因素。使用多元线性回归测试评估与功能结局相关的危险因素。
在受伤后1年的最终随访中，FAOS在损伤严重程度、年龄和BMI方面存在显著差异。在性别、工作活动和运动水平方面没有显著差异。对疼痛（FAOS-疼痛）和症状（FAOS-症状）影响最大的因素是完全撕裂韧带的数量。年龄是影响FAOS-日常生活活动（ADL）的最重要因素。BMI是体育活动水平（FAOS-运动）的最重要因素。年龄和完全撕裂韧带的数量对FAOS-运动和生活质量（FAOS-QOL）都很重要。
使用US定义的损伤严重程度是急性踝关节扭伤后长期结局的预后因素。因此，急性踝关节韧带损伤的US成像对于预测急性踝关节扭伤的预后可能很重要。
