Uchida Yuto, Kawabata Masashi, Kumazawa Yusuke, Takagi Kazuya, Miyatake Kazuma, Kobayashi Takumi, Kenmoku Tomonori, Watanabe Hiroyuki, Takahira Naonobu
Department of Sports Medicine Kitasato University Graduate School of Medical Sciences Sagamihara Japan.
Rehabilitation Center Sagamihara Kyodo Hospital Sagamihara Japan.
J Exp Orthop. 2025 Mar 22;12(1):e70204. doi: 10.1002/jeo2.70204. eCollection 2025 Jan.
There is no consensus on treatment protocols based on severity and timing for acute lateral ankle sprain (LAS). Appropriate decision-making is necessary to prevent reinjury or chronic ankle instability. In this retrospective observational study, we clarified the duration of recovery from anterior ankle joint displacement in patients with initial acute LAS of several severities.
Overall, 101 patients with varying grades of initial unilateral LAS were included. Injury severity was based on ligament tears and anterior ankle joint displacement using the reverse anterior drawer test with ultrasonography. The automated length measurement system software measured changes in the talofibular distance.
The median (95% confidence interval) change in the talofibular distance on the affected side was 1.24 (0.96-1.76), 3.03 (2.91-3.74) and 3.06 (2.37-4.69) mm for LAS grades I, II and III, respectively, on the first medical examination. The increase in talofibular distance for grade I injuries was significantly smaller than for Grades II and III ( < 0.01). The regression equation was = -0.02 × days + 1.43, -0.05 × days + 3.30 and -0.05 × days + 3.42 for Grades I, II and III, respectively; the time it took to reach the value of the unaffected side was 14.5, 43.2 and 45.6 days, respectively. Regression coefficients were significantly greater for Grades II and III than for Grade I ( < 0.01 and = 0.01, respectively). No significant differences were observed between Grades II and III.
These results revealed that the recovery time for displacement varies according to the severity of the sprain, suggesting the need to develop optimal treatment protocols.
Level III.
对于急性外侧踝关节扭伤（LAS）基于严重程度和时间的治疗方案尚无共识。做出恰当的决策对于预防再次受伤或慢性踝关节不稳是必要的。在这项回顾性观察研究中，我们明确了不同严重程度的初次急性LAS患者踝关节前侧移位的恢复时长。
总共纳入了101例不同程度的初次单侧LAS患者。损伤严重程度基于韧带撕裂情况以及使用超声反向前抽屉试验评估的踝关节前侧移位情况。自动长度测量系统软件测量胫腓距的变化。
在首次医学检查时，I级、II级和III级LAS患侧胫腓距的中位数（95%置信区间）变化分别为1.24（0.96 - 1.76）、3.03（2.91 - 3.74）和3.06（2.37 - 4.69）mm。I级损伤胫腓距的增加显著小于II级和III级（<0.01）。I级、II级和III级的回归方程分别为=-0.02×天数 + 1.43、-0.05×天数 + 3.30和-0.05×天数 + 3.42；达到未受伤侧数值所需时间分别为14.5天、43.2天和45.6天。II级和III级的回归系数显著大于I级（分别为<0.01和=0.01）。II级和III级之间未观察到显著差异。
这些结果显示，移位的恢复时间因扭伤严重程度而异，提示需要制定最佳治疗方案。
III级。
