De Simoni C, Wetz H H, Zanetti M, Hodler J, Jacob H, Zollinger H
Department of Orthopaedic Surgery, Balgrist University of Zurich, Switzerland.
Foot Ankle Int. 1996 Mar;17(3):177-82. doi: 10.1177/107110079601700312.
This is a prospective clinical study of treatment of ankle sprains with an ankle brace that permits ankle dorsiflexion and plantarflexion of 20 degrees, but limits inversion and eversion for 6 weeks. The ankle brace is followed by physiotherapy for another 6 weeks. Thirty patients were evaluated with clinical examination and magnetic resonance (MR) imaging before treatment and after 12 weeks of treatment. MR imaging revealed acute tears in the anterior talofibular ligament in all 30 ankles (100%) and tears in the calcaneofibular ligament in 25 of 30 ankles (83%). At 12 weeks after injury, MR evidence of healing was present for the anterior talofibular ligament in 22 of 30 ankles (73%) and for the calcaneofibular ligament in 23 of 25 ankles (92%). Postural sway analysis after therapy was used to quantify functional stability of the ankle. There was no correlation with MR findings, but there was a correlation with the subjective impression of functional instability. Twenty-eight of 30 patients (93%) had a functionally stable ankle after 12 weeks of treatment. MR findings after ankle sprain could not predict clinical outcome.
这是一项前瞻性临床研究，旨在使用一种允许踝关节背屈和跖屈20度，但在6周内限制内翻和外翻的踝关节支具治疗踝关节扭伤。佩戴该踝关节支具后，再进行6周的物理治疗。对30例患者在治疗前及治疗12周后进行了临床检查和磁共振（MR）成像评估。MR成像显示，所有30个踝关节（100%）的距腓前韧带均有急性撕裂，30个踝关节中有25个（83%）的跟腓韧带撕裂。受伤12周后，30个踝关节中有22个（73%）的距腓前韧带出现MR愈合证据，25个踝关节中有23个（92%）的跟腓韧带出现MR愈合证据。治疗后采用姿势摆动分析来量化踝关节的功能稳定性。其与MR检查结果无相关性，但与功能不稳定的主观印象相关。30例患者中有28例（93%）在治疗12周后踝关节功能稳定。踝关节扭伤后的MR检查结果无法预测临床疗效。
