Yang Yimeng, Wu Yang, Zhu Wenhui
Department of Sports Medicine, Huashan Hospital, Shanghai, 200040, China.
Department of Sports Medicine, Huashan Hospital, Shanghai, 200040, China.
Chin J Traumatol. 2025 Jan;28(1):35-42. doi: 10.1016/j.cjtee.2024.07.011. Epub 2024 Nov 7.
Ankle sprains are the most common lesion of the ankle joint which might result in chronic ankle instability (CAI). Significant strides have been taken to enhance our comprehension of the underlying mechanisms of CAI, as the exploration of novel surgical techniques and the identification of previously unrecognized anatomical components. The present review aims to provide an extensive overview of CAI, encompassing its pathophysiology, epidemiology, clinical assessment, treatment, and rehabilitation. Treatment of CAI requires a multifaceted algorithm, involving historical analysis, clinical evaluations, and diagnostic imaging. Surgical interventions for CAI primarily involve the anatomical and/or non-anatomical reconstruction and/or repair of the anterior talofibular ligament. Anatomical repair has exhibited superior functional outcomes and a reduced risk of secondary osteoarthritis compared to non-anatomical repair. Non-anatomical approaches fall short of replicating the normal biomechanics of the anterior talofibular ligament, potentially leading to postoperative stiffness. This review seeks to academically review and up-to-date literature on this issue, tailored for clinical practice, with the intent of aiding surgeons in staying abreast of this critical subject matter.
踝关节扭伤是踝关节最常见的损伤,可能导致慢性踝关节不稳(CAI)。随着新型手术技术的探索和先前未被认识的解剖结构的发现,我们在理解CAI潜在机制方面取得了重大进展。本综述旨在全面概述CAI,包括其病理生理学、流行病学、临床评估、治疗和康复。CAI的治疗需要多方面的方案,包括病史分析、临床评估和诊断性影像学检查。CAI的手术干预主要涉及距腓前韧带的解剖和/或非解剖重建及/或修复。与非解剖修复相比,解剖修复已显示出更好的功能结果和更低的继发性骨关节炎风险。非解剖方法无法复制距腓前韧带的正常生物力学,可能导致术后僵硬。本综述旨在对该问题进行学术性回顾并更新相关文献,以适应临床实践,帮助外科医生紧跟这一关键主题。