慢性踝关节不稳的诊断与修复

Diagnosis and repair of chronic ankle instability

背景:慢性踝关节不稳会对正常的生活造成严重的影响。因此,慢性踝关节不稳得到越来越多的专家重视,而慢性踝关节不稳患者早期合理有效的诊断和针对性的治疗方法的选择在临床上已经成为一个重要的课题。目的:回顾近年来慢性踝关节不稳的诊断及治疗方法的文献研究,为临床实践中慢性踝关节不稳的诊断及合理有效的治疗提供参考和评价标准。方法:计算机检索PubMed数据库、中国期刊全文数据库(CNKI)、万方和维普数据库有关慢性踝关节不稳的临床及基础实验研究,检索关键词分别为"慢性踝关节,不稳,诊断,康复锻炼,手术方法,研究进展"和"Chronic ankle,Instability,Diagnosis,Rehabilitation exercises,Surgical methods,Research"。共纳入40篇文献进行分析。结果与结论:由于踝关节特殊的解剖结构特征和生物力学优点,在针对慢性踝关节不稳的患者应首先考虑早期的诊断和有效的治疗方法。而治疗方法应综合踝关节的解剖结构特点、生物力学特征、慢性踝关节的发病原因和诊断方法等各方面的因素决定。保守治疗和手术治疗后的康复锻炼对慢性踝关节不稳的恢复起着重大作用。平衡板、倾斜板、登山机的使用是慢性踝关节不稳康复锻炼的有效手段。AOFOS-踝后足和腓骨肌反应时间的应用对踝关节功能恢复的评定有重要意义。关节镜的出现是踝关节的手术治疗中重大的临床研究方向。这对于慢性踝关节不稳的治疗起着显著的效果。

BACKGROUND： Chronic ankle instability affects normal life severely. Therefore, chronic ankle instability causes more and more attention of experts, and choice of reasonable and effective diagnosis and targeted treatment method for chronic ankle instability in early stage has become an important issue in the clinic. OBJECTIVE： To review literature research on the diagnosis and treatment of chronic ankle instability in recent years, and to provide reference and evaluation criteria for the diagnosis and reasonable and effective treatment of chronic ankle instability in clinical practice. METHODS： We searched PubMed database, China National Knowledge Infrastructure, Wanfang database and VlP database for clinical and basic experimental research on chronic ankle instability. Keywords were ＂chronic ankle, instability, diagnosisl rehabilitation exercises, surgery methods, research progress＂ in Chinese and ＂chronic ankle, instability, diagnosis, rehabilitation exercises, surgical methods, research＂ in English. Totally 40 literatures were analyzed： RESULTS AND CONCLUSION： Because of the special anatomical features and biomechanical advantages of the ankle, we should first consider the early diagnosis and effective treatment in chronic ankle instability patients.The treatment should focus on the anatomic characteristics, biomechanic characteristics, etiology of chronic ankle and diagnostic methods of the ankle joint. Conservative treatment and rehabilitation exercises after surgery play a major role in the recovery of chronic ankle instability. The use of balance board, tilting board, and climbing machines is an effective rehabilitation exercises for chronic ankle instability. The application of AOFOS-hind foot and ankle fibula reaction time is important for the assessment of functional recovery of the ankle joint. The emergence of arthroscope is an important clinical research direction of ankle surgery. This plays a significant effect on the treatment of chronic ankle instability.