中跗关节扭伤的磁共振成像：在职业足球运动员中的发生率及其对重返赛场时间的影响。
Magnetic resonance imaging of midtarsal sprain: Prevalence and impact on the time of return to play in professional soccer players.
机构信息
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
UKE Athleticum, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
出版信息
Eur J Radiol. 2021 Feb;135:109491. doi: 10.1016/j.ejrad.2020.109491. Epub 2020 Dec 24.
BACKGROUND
Ankle sprain is a common injury in professional soccer, but to date midtarsal sprain has not been investigated in this context. The purpose of this study was to determine the prevalence of midtarsal sprain by MRI and to assess its impact on the time of return to play in professional soccer players.
METHODS
We included 52 professional soccer players who underwent 59 MRI examinations after acute ankle trauma between January 2012 and September 2019. Images were retrospectively reviewed in consensus by two radiologists for assessment of midtarsal sprain and ankle sprain. Ligaments were graded as i) normal, ii) partial tear, or iii) complete tear. Time to return to play (RTP) for each athlete was retrieved from team medical records. A Kruskal-Wallis test and Dunn's pairwise tests were used to calculate differences in RTP time between groups with i) isolated midtarsal sprain, ii) isolated lateral ankle sprain, and iii) combined midtarsal and lateral ankle sprain.
RESULTS
MRI revealed isolated ankle sprain in 24 of 59 MRI examinations (40.6 %). Acute midtarsal ligament injury was present in 15 examinations (25.4 %). Four of the 15 examinations (26.7 %) had isolated midtarsal injuries and eleven of the 15 examinations (73.3 %) had concomitant ankle sprain. RTP time was 39 days (range 9-70 days) for isolated midtarsal sprain. RTP time was significantly higher for athletes with combined ankle and midtarsal sprain (47 days, range 15-74 days) when compared to athletes with isolated ankle sprain (24 days, range 2-59 days) (p = .019).
CONCLUSION
Our MRI study reveals that midtarsal sprain is a frequent injury in professional soccer players with ankle sprain. Midtarsal ligament findings on MRI combined with evidence of lateral ankle sprain is associated with a longer time of return to play compared to isolated lateral ligament injuries.
LEVEL OF EVIDENCE
Retrospective study, observational study.
背景
踝关节扭伤是职业足球中常见的损伤，但迄今为止，中跗关节扭伤在这方面尚未得到研究。本研究的目的是通过 MRI 确定中跗关节扭伤的患病率，并评估其对职业足球运动员重返赛场时间的影响。
方法
我们纳入了 2012 年 1 月至 2019 年 9 月期间因急性踝关节外伤接受 59 次 MRI 检查的 52 名职业足球运动员。由两名放射科医生对 MRI 进行回顾性评估，以评估中跗关节扭伤和踝关节扭伤。韧带分为 i) 正常、ii) 部分撕裂或 iii) 完全撕裂。从球队医疗记录中检索每位运动员的重返赛场时间（RTP）。使用 Kruskal-Wallis 检验和 Dunn 两两比较检验，计算 i) 单纯中跗关节扭伤、ii) 单纯外侧踝关节扭伤和 iii) 中跗关节和外侧踝关节扭伤合并的组间 RTP 时间差异。
结果
MRI 显示 24 次 MRI 检查（40.6%）存在单纯踝关节扭伤。15 次检查显示急性中跗韧带损伤（25.4%）。4 次检查（26.7%）为单纯中跗关节损伤，11 次检查（73.3%）为合并踝关节扭伤。单纯中跗关节扭伤的 RTP 时间为 39 天（9-70 天）。与单纯踝关节扭伤（24 天，2-59 天）相比，合并踝关节和中跗关节扭伤的运动员的 RTP 时间明显更高（47 天，15-74 天）（p=0.019）。
结论
我们的 MRI 研究表明，中跗关节扭伤是职业足球运动员踝关节扭伤的常见损伤。MRI 上中跗韧带的发现结合外侧踝关节扭伤的证据与单纯外侧韧带损伤相比，与重返赛场的时间较长相关。
证据水平
回顾性研究，观察性研究。
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