Wülker N, Wirth C J, Rudert M
Orthopädische Klinik der Medizinischen Hochschule Hannover im Annastift e.V.
Z Orthop Ihre Grenzgeb. 1996 Mar-Apr;134(2):149-54. doi: 10.1055/s-2008-1039787.
The treatment of lateral ankle ligament tears has been by conservative and by operative means. 483 patients treated by a number of orthopaedic surgeons, general surgeons and trauma surgeons in Germany over a 2 1/2 year period were questioned one year after the injury. Treatment had been conservatively in 325 patients (tape bandage, elastic bandage, plaster cast, ankle brace, Aircast brace, others) and operatively in 158 patients (primary ligament repair, ligament reconstruction). A 100 point subjective ankle score was used for the 420 patients who responded. The mean score was 90.5 points. The average score of all patients undergoing surgery was 88.2 points, the mean score of all conservatively treated patients was 91.7 points. However, instability on stress radiographs after the injury was less in the conservative group. There was no clear correlation between the initial radiographic instability and the follow-up result. Young patients did better than older patients. The authors recommend conservative, early functional treatment for lateral ankle ligament tears.
外侧踝关节韧带撕裂的治疗方法包括保守治疗和手术治疗。在德国,由多名骨科医生、普通外科医生和创伤外科医生在两年半的时间里治疗的483例患者在受伤一年后接受了询问。325例患者接受了保守治疗(胶带绷带、弹力绷带、石膏、踝关节支具、Aircast支具等),158例患者接受了手术治疗(一期韧带修复、韧带重建)。对420例有回应的患者使用了100分的主观踝关节评分。平均分数为90.5分。所有接受手术的患者的平均分数为88.2分,所有接受保守治疗的患者的平均分数为91.7分。然而,保守治疗组受伤后应力位X线片显示的不稳定情况较少。初始X线片显示的不稳定与随访结果之间没有明显的相关性。年轻患者的治疗效果优于老年患者。作者建议对外侧踝关节韧带撕裂采用保守、早期功能治疗。