Jain Neil, Murray David, Kemp Steve, Calder James
Manchester Institute of Health & Performance, Manchester, UK.
The Football Association, Burton-upon-Trent, UK.
Foot Ankle Orthop. 2023 Aug 11;8(3):24730114231195048. doi: 10.1177/24730114231195048. eCollection 2023 Jul.
Ankle syndesmosis injuries in professional soccer may lead to an unpredictable and prolonged recovery. This injury has been investigated in anatomical and radiologic studies but the precise mechanism leading to syndesmosis injury is not well understood and remains debated. The 2 goals of this study were to (1) evaluate the relationship between the mechanism of syndesmosis injury as determined by high-speed video analysis and the injured structures identified by clinical and radiologic examination and to (2) investigate the relationship between mechanism of injury and time of return to play.
This pilot study prospectively reviewed high-speed video analysis of 12 professional soccer players who sustained syndesmosis injuries. The mechanism of injury was compared with the clinical and MRI evaluation and the time taken to return to play.
Higher-grade syndesmosis injuries occurred during ankle external rotation with dorsiflexion. Supination-inversion injuries with a standard lateral ankle sprain (rupture of the anterior talofibular ligament) may extend proximally, causing a lower-grade syndesmosis injury. These may present with signs of a high ankle sprain but have a quicker return to sport than those following a dorsiflexion-external rotation injury (mean 26 days vs 91 days).
Video analysis confirmed that at least 2 mechanisms may result in injury to the ankle syndesmosis. Those "simple" ankle sprains with signs of syndesmosis injury had a quicker return to play. This new finding may be used by club medical teams during their initial assessment and help predict the expected time away from soccer in players with suspected high ankle sprains.
Level IV, retrospective cohort study.
职业足球运动员的踝关节下胫腓联合损伤可能导致不可预测的长期恢复。解剖学和放射学研究已对该损伤进行了调查,但导致下胫腓联合损伤的确切机制尚未完全明确,仍存在争议。本研究的两个目标是:(1)评估通过高速视频分析确定的下胫腓联合损伤机制与临床和放射学检查所确定的损伤结构之间的关系;(2)研究损伤机制与重返比赛时间之间的关系。
本前瞻性试点研究回顾性分析了12名发生下胫腓联合损伤的职业足球运动员的高速视频分析资料。将损伤机制与临床及MRI评估结果以及重返比赛所需时间进行比较。
更严重的下胫腓联合损伤发生于踝关节背屈伴外旋时。伴有标准外侧踝关节扭伤(距腓前韧带断裂)的旋后-内翻损伤可能向近端延伸,导致较轻程度的下胫腓联合损伤。这些损伤可能表现为高位踝关节扭伤的体征,但比背屈-外旋损伤后的恢复时间更快(平均26天对91天)。
视频分析证实,至少有两种机制可能导致踝关节下胫腓联合损伤。那些伴有下胫腓联合损伤体征的“单纯”踝关节扭伤恢复比赛的时间更快。这一新发现可被俱乐部医疗团队用于初步评估,并有助于预测疑似高位踝关节扭伤球员的预期停赛时间。
IV级(回顾性队列研究)