Rzonca E C, Lue B Y
Division of Orthopedic Sciences, New York College of Podiatric Medicine, New York.
Clin Podiatr Med Surg. 1988 Jul;5(3):661-75.
As has been previously discussed, the incidence and resultant associated disabilities of ankle sprains have been well documented in the literature. The staggering statistics on long-term disability show that there is no such thing as a simple ankle sprain. The degree of disability is related to the extent of the initial injury as well as the follow-up medical care provided. It is this fact that requires a complete understanding of the injury as well as a proper treatment and rehabilitation program. One of the reasons cited for the long-term disability or lack of consistently good results in treating ankle sprains is the lack of uniformity in treatment. One possible reason is the lack of agreement in diagnostic techniques as well as the end diagnosis of a particular grade of ankle sprain. If a sprain is managed correctly, resultant disability will be kept to a minimum. A proper rehabilitation program may be the most important factor in preventing chronic instability. The acronym RICE falls short of complete ankle management. RICE primarily addresses the ankle edema. Thus, the patient's ankle is only partially rehabilitated. A rational approach to the management of ankle sprains is given. Upon reviewing a complete protocol for ankle sprain rehabilitation, the acronym TEMPER can be used judiciously to remember the key steps in the treatment plan. Through the use of this acronym, one can institute a complete rehabilitation program.
如前所述,踝关节扭伤的发病率及由此导致的相关残疾在文献中已有充分记载。关于长期残疾的惊人统计数据表明,不存在简单的踝关节扭伤这种情况。残疾程度与初始损伤的程度以及后续提供的医疗护理有关。正是这一事实要求对损伤有全面的了解以及制定适当的治疗和康复计划。在治疗踝关节扭伤时,导致长期残疾或缺乏始终良好效果的原因之一是治疗缺乏一致性。一个可能的原因是诊断技术以及特定等级踝关节扭伤的最终诊断缺乏一致性。如果扭伤处理得当,由此导致的残疾将降至最低。适当的康复计划可能是预防慢性不稳定的最重要因素。“RICE”(休息、冰敷、加压包扎、抬高)这一方法不足以对踝关节进行全面管理。“RICE”主要解决踝关节水肿问题。因此,患者的踝关节只是部分得到康复。本文给出了一种合理的踝关节扭伤处理方法。在回顾踝关节扭伤康复的完整方案时,“TEMPER”这一缩写词可明智地用于记住治疗计划中的关键步骤。通过使用这个缩写词,人们可以制定一个完整的康复计划。