Röder W, Hennes R, Grebe P, Isemer F E
Abteilung für Allgemein- und Unfallchirurgie, St. Josefs-Hospital Wiesbaden.
Unfallchirurg. 1994 Sep;97(9):467-71.
The therapy of fibular ligament ruptures is still a controversial subject. Reports on healing processes following operative or conservative treatment have been verified hitherto by means of clinical examinations and stress tests. The MRT, as a highly sensitive non-invasive method, allows exact documentation of the ligament structures in the ankle joints. This technique was used in a randomized clinical trial over a 6-month period. The 29 patients (ages 17-51 years) had recent ligament rupture [admission criteria: clinical signs of trauma, talar tilt in anteroposterior stress radiographs (15 kp) > or = 10 degrees, talar shift > or = 10 mm] were examined with regard to ligament healing during functional therapy with AIRCAST pneumatic leg braces. Within the first week an MRT was done for verification of ligament injury. Treatment was conservative and functional: lower leg cast for 2 weeks and subsequent mobilization with protection provided by an AIRCAST brace. Follow-up examination was 3 months after injury, taking the form of clinical examination, a-p-radiographs with stress tests, and MRT. In all patients both clinical and radiological examination confirmed that ligament structures had healed, as was also verified by MRT.
腓骨韧带断裂的治疗仍然是一个有争议的话题。迄今为止,关于手术或保守治疗后愈合过程的报告都是通过临床检查和应力测试来证实的。磁共振成像(MRT)作为一种高度敏感的非侵入性方法,能够准确记录踝关节的韧带结构。在一项为期6个月的随机临床试验中使用了该技术。29例患者(年龄17 - 51岁)近期发生韧带断裂[纳入标准:有创伤的临床体征,前后位应力X线片(15kp)下距骨倾斜≥10度,距骨移位≥10mm],在使用AIRCAST气动腿部支具进行功能治疗期间,对韧带愈合情况进行了检查。在第一周内进行了磁共振成像检查以证实韧带损伤。治疗采用保守且功能性的方法:小腿石膏固定2周,随后在AIRCAST支具的保护下进行活动。在受伤3个月后进行随访检查,包括临床检查、带应力测试的前后位X线片以及磁共振成像。在所有患者中,临床和放射学检查均证实韧带结构已愈合,磁共振成像也验证了这一点。