Ogilvie-Harris D J, Gilbart M
Department of Orthopaedic Surgery, University of Toronto, Ontario, Canada.
Clin J Sport Med. 1995 Jul;5(3):175-86. doi: 10.1097/00042752-199507000-00008.
We reviewed the English language medical literature on soft tissue injuries of the ankle published between 1966 and 1993. There were 150 articles reviewed of which 84 dealt substantially with ankle soft tissue injuries. The papers were analyzed for quality and it was found that there were significant weaknesses throughout the literature. This related particularly to randomization, blinded assessment, and outcome measures. The results of the treatment of 32,025 patients were reported in 84 studies. We were unable to gather sufficient data from these studies to perform a statistical analysis of the different forms of treatment. Our conclusions were that nonsteroidal antiinflammatory drugs shortened the time period to recovery and were associated with less pain. Active mobilization appeared to be the treatment of choice. Studies also showed that cryotherapy was of benefit and diapulse may be helpful. There was insufficient evidence to conclude that enzyme treatment, topical gels, ultrasound or diathermy, joint aspiration of injection were of benefit. Overall the literature would substantiate active mobilization following ankle sprains with judicious early use of nonsteroidal antiinflammatory drugs and the use of cryotherapy and diapulse in the treatment of ankle injuries. Our study suggests further investigations need to be carried out into the effectiveness and outcomes following alternative forms of therapy for ankle injuries.
我们回顾了1966年至1993年间发表的关于踝关节软组织损伤的英文医学文献。共查阅了150篇文章，其中84篇主要涉及踝关节软组织损伤。对这些论文进行了质量分析，发现整个文献存在显著缺陷。这尤其与随机化、盲法评估和结果测量有关。84项研究报告了32025例患者的治疗结果。我们无法从这些研究中收集足够的数据来对不同治疗方式进行统计分析。我们的结论是，非甾体抗炎药缩短了恢复时间，且疼痛较轻。主动活动似乎是首选治疗方法。研究还表明，冷冻疗法有益，短波透热疗法可能有帮助。没有足够的证据得出酶治疗、局部凝胶、超声或透热疗法、关节穿刺注射有益的结论。总体而言，文献支持踝关节扭伤后进行主动活动，明智地早期使用非甾体抗炎药，以及在踝关节损伤治疗中使用冷冻疗法和短波透热疗法。我们的研究表明，需要进一步研究踝关节损伤替代治疗方式的有效性和结果。
