慢性踝关节不稳的争议问题

Controversial issues of chronic ankle instability

慢性踝关节不稳是踝关节初次内翻扭伤后出现的以反复扭伤、感觉不稳、疼痛、肿胀等症状为特点的慢性运动损伤性疾病。对于慢性踝关节不稳的病理机制研究仍然无法解释疾病表现的多样性。慢性踝关节不稳的手术指征既往仅强调机械性关节松弛,但外踝扭伤后出现慢性症状前来就诊的患者,多数可能并没有典型的机械性不稳的主诉,更多的患者是以迁延不愈的疼痛或功能性不稳为主诉的。手术治疗对功能性不稳症状也有一定效果,但功能性不稳的手术指征主要依据主观症状,目前缺乏客观指标,仍有争议。需要进一步深入进行慢性踝关节不稳的机制研究,从而指导诊疗策略的制定。

Chronic ankle instability is a chronic sports injury disease characterized by recurrent sprains,feeling of instability,pain,swelling and other symptoms after an initial sprain.Research on the pathological mechanism of chronic ankle instability still cannot explain the diversity of symptoms.In the past,the surgical indications for chronic ankle instability only emphasized mechanical joint laxity.However,most patients with chronic symptoms after a lateral ankle sprain may not have a typical complaint of mechanical instability.More patients presented with persistent pain or functional instability as the chief complaint.Surgical treatment also has a certain effect on the symptoms of functional instability,but the surgical indications of functional instability are mainly based on subjective symptoms.At present,there is a lack of objective indicators for surgery,which is still controversial.Further in-depth research on the mechanism of chronic ankle instability is needed to guide the formulation of diagnosis and treatment strategies.