Sommer H M, Arza D
Orthopädische Universitätsklinik Heidelberg.
Sportverletz Sportschaden. 1987 Apr;1(1):25-9. doi: 10.1055/s-2007-993691.
In a prospective randomised study we examined 80 men and women of 18 to 45 years of age and 40 competitive sportsmen and sportswomen with fresh ruptures of the talofibular and calcaneofibular ligaments treated either surgically or conservatively by functional bracing. We controlled the results by anamnesis and by clinical and radiological follow-up. Conservative treatment leads to the same results after 3-8 months as surgical treatment (5 +/- 2 degrees of talar angulation). Functional conservative treatment results in earlier painless weight bearing in comparison to the surgical treatment which was, however, combined with three weeks immobilization directly after surgery. This proves the superiority of the early functional conservative treatment as long as there are no bony capsuloligamentous tears, osseocartilaginous lesions of the joint surface with splintered-off chips or "flakes" of cartilage ("flake fractures") or reruptures of a chronically unstable ankle joint. The similarly good results achieved in the group of 40 sportsmen and sportswomen by early functional conservative treatment do not justify operation of ruptures of the talofibular and calcaneofibular ligaments.
在一项前瞻性随机研究中，我们检查了80名年龄在18至45岁之间的男性和女性，以及40名患有距腓韧带和跟腓韧带新鲜断裂的竞技男女运动员，他们接受了手术治疗或通过功能性支具进行保守治疗。我们通过问诊以及临床和放射学随访来控制结果。保守治疗在3至8个月后与手术治疗产生相同的结果（距骨成角5±2度）。与手术治疗相比，功能性保守治疗能使患者更早地无痛负重，不过手术治疗术后需直接固定三周。这证明了早期功能性保守治疗的优越性，只要不存在骨膜韧带撕裂、关节面骨软骨损伤伴软骨碎片或“薄片”（“薄片骨折”）或慢性不稳定踝关节再断裂。在40名男女运动员组中，早期功能性保守治疗取得了同样良好的效果，这表明距腓韧带和跟腓韧带断裂无需进行手术。
