弹性有限制动方式在演训部队急性踝关节外侧副韧带损伤中的应用

Application of Elastic Limited Immobilisation for Acute Ankle Ligament Injury in Training Army

目的探讨应用弹性自粘绷带有限制动治疗演训部队急性踝关节韧带损伤的方法及近期疗效。方法 2017-05～07月朱日和训练基地医院收治43例演训部队中的急性踝关节韧带损伤患者,其中男41例,女2例,年龄18～25岁,平均21.6岁;高频超声检查提示Ⅰ度损伤7例,Ⅱ度损伤35例;针对性采用弹性自粘绷带8字缠绕有限制动,间断冰敷,次日开始穿作战靴逐步恢复功能锻炼的综合治疗措施,依据美国矫形足踝协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分标准及视觉模拟评分(visual analogue scale,VAS)标准进行功能评定。结果本组获得8～12(平均9.2)个月的随访,所有患者均在3～7 d恢复正常训练,7例出现皮肤过敏现象,末次电话随访评估AOFAS评分从伤后的34～70(平均65.3)分提高到85～100(平均90.5)分;VAS评分从伤后的5～8(平均6.3)分提高到0～3(平均0.7)分;末次随访时5例患者诉有慢性疼痛及关节不稳征象。结论应用弹性自粘绷带有限制动方式治疗演训部队的急性踝关节韧带损伤,配合间断冰敷,功能恢复更快,并发症较少。

Objective To explore the method and short-term results of elastic self-adhesive bandage and limited immobilization for acute ankle ligament injury in training army.Methods During May 2017 to July 2017,43 cases of training soldiers with acute ankle ligament injury were treated in Zhurihe Training Base Hospital.Among them,41 males,2 females,aged from 18 to 25 years old,averaged 21.6 years.High frequency ultrasonic examination showed that there were 7 cases of gradeⅠinjury and35 cases of gradeⅡinjury.The injured ankle was limited with elastic self-adhesive bandage according to＂8＂shape,intermittent cryotherapy,the next day starting to wear combat boots to gradually resume walking.The functional evaluation was performed according to the ankle and hind foot score of the American Orthopaedic Foot and Ankle Society（AOFAS）and the visual analogue scale（VAS）.Results The follow-up period was 8-12 months（mean 9.2 months）.All patients returned to normal training after 3 to 7 days.Skin allergy occurred in 7 cases.The AOFAS score increased from an average of 65.3（34-70）score after injury to an average of 90.5（85-100）score.VAS scores incresed from an average of 6.3（5-8）score after injury to an average of 0.7（0-3）score.Five cases with chronic pain and ankle instability were found at the last follow-up.Conclusion The application of limited immobilization with elastic self-adhesive bandage plus intermittent cryotherapy for acute ankle ligament injury in training army is faster and less complications.