BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the mod...BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the modern cast.The Opencast®is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related complications.Although this novel cast appears to have more benefits than the conventional synthetic cast,its clinical efficacy and advantages have not been established.AIM To investigate the clinical efficacy and advantages of the newly developed Opencast®based on patients’perspectives in those with ankle inversion injury.METHODS A specifically designed questionnaire consisting of 19 items was used to compare patients’opinions and concerns of the Opencast®and the conventional synthetic cast.The items were focused on subjective patient satisfaction,discomfort,and adverse effects while wearing the cast.Patients with an ankle inversion injury diagnosed as a high-grade ankle sprain were enrolled.The subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast®for 2 wk.They were then required to fill the questionnaire again,after switching to the alternative type of cast for 2 more weeks.RESULTS A total of 22 subjects participated in the study.The synthetic cast appeared to be more rigid and stable than the Opencast®,but there was no significant difference in the amount of pain relief.The likelihood of adverse effects when wearing the synthetic cast was significantly higher.Patient satisfaction tended to be rated higher after wearing the Opencast®.Opencast®showed more subjective vulnerability than the synthetic cast,but there was no significant difference in the redo rate.Patients were more anxious about removal of the synthetic cast than of the Opencast®.CONCLUSION The results indicate that the Opencast®could replace the conventional synthetic cast as it offers increased patient satisfaction,which would in turn increase compliance to treatment.展开更多
Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The pr...Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The present paper examines some subjects with a previous history of acute inversion ankle sprain who have developed a subsequent condition of instability, grouping them according to inclusion criteria and analyzing them through four field tests considered objective by the scientific literature: SEBT test, BEES test, TIBT test, SHT test. The data obtained were stored in order to compare them following a re-education protocol aimed at improving proprioception, balance, walking and strengthening the extrinsic and intrinsic muscles of the foot. per year. The subjects were then divided into two categories: subjects with CAI > 1 year and subjects with CAI ≤ 1 year. A protocol lasting 6 weeks was administered to both groups, trying to work on improving balance in single stance, improving static and dynamic stability, strengthening the gluteus medius and maximus (pelvis stabilizers) and strengthening of the intrinsic muscles of the foot. At the end of the protocol the subjects were all re-evaluated with the same field tests used previously and the data obtained were compared both with the pre-protocol data and with the data measured by the control subjects.展开更多
BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this...BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.展开更多
Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial ri...Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial risk for developing CAI.This study identifies magnetic resonance imaging(MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.Methods:All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1,2017 to December 1,2019 were identified.Data were collected using the Cumberland Ankle Instability Tool at final follow-up.Demographic and other related clinical variables,including age,sex,body mass index,and treatment were also recorded.Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.Results:A total 131 out of 362 patients with a mean follow-up of 3.0± 0.6 years(mean ± SD;2.0—4.1 years) developed CAI after first-episode LAS.According to multivariable regression,development of CAI after first-episode LAS was associated with 5 prognostic factors:age(odds ratio(OR)=0.96,95% confidence interval(95%CI):0.93-1.00,p=0.032);body mass index(OR=1.09,95%CI:1.02-1.17,p=0.009);posterior talofibular ligament injury(OR=2.17,95%CI:1.05-4.48,p=0.035);large bone marrow lesion of the talus(OR=2.69,95%CI:1.30-5.58,p=0.008),and Grade 2 effusion of the tibiotalar joint(OR=2.61,95%CI:1.39-4.89,p=0.003).When patients had at least 1 positive clinical finding in the 10-m walk test,anterior drawer test,or inversion tilt test,they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.Conclusion:MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the10-m walk test,anterior drawer test,and inversion tilt test.Further prospective and large-scale studies are necessary for validation.展开更多
Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus,...Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.展开更多
Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace(Element<sup>TM</sup>) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces...Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace(Element<sup>TM</sup>) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces(GRFs) during a drop landing activity in subjects with chronic ankle instability(CAD compared to healthy subjects with no history of CAI. Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects, respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace(NB).Element<sup>? </sup>brace and ASO brace.Simultaneous recording of three-dimensional kinematic(240 Hz) and GRF(1200 Hz) data were performed. Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of Element<sup>TM</sup> against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy controls.The ASO brace reduced the first peak vertical GRF whereas Element<sup>TM</sup> increased 2nd peak vertical GRF. Element<sup>TM</sup>brace reduced eversion range of motion(ROM) and peak eversion velocity compared to NB and ASO.In addition,Element<sup>TM</sup> reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO. Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for Element<sup>TM</sup>.展开更多
Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains aff...Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains affect the lateral ligaments,particularly the anterior talofibular ligament.Despite its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic cornerstones.Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules.Several interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.An exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific exercises.Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance testing.There are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and avoid.These include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate rehabilitation.The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.展开更多
Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclus...Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclusion criteria for CAL We investigated the prevalence of pain inpeople with CAI and the association between presence of pain and other CAI characteristics.Methods'. Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that usedthe Cumberland Ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland Ankle Instability Tool, whichasks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physicalactivities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteris・tics was analyzed by /2 tests and factors associated with each pain category were analyzed by logistic regression.Results'. Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities,47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong associationbetween ankle instability and ankle pain (/2 = 122.2, p < 0.001, OR = 53& 95% confidence interval (CI): 3.84—7.53). Perceived ankle instability,age and unilateral ankle sprains were independently associated with pain (ankle instability: /2 = 43.29, p < 0.001;age: /2 = 30.37,p < 0.001;unilateral ankle sprains: /2 = 6.25, p < 0.05). There was no significant difference in the presence of pain between genders.Conclusion-. The prevalence of pain in people with CAI was high and was related to perceived ankle instability. Number of sprains, age, genderand unilateral or bilateral sprain did not modify this result except for the first pain category (pain during daily activities). There is large gap incurrent knowledge about the impact of pain in people with CAI, and this topic needs further investigation.展开更多
Background:Several case studies observed that the lateral ankle sprain resulted from a sudden increase in ankle inversion accompanied by internal rotation.However,without sufficient ankle kinetics and muscle activity ...Background:Several case studies observed that the lateral ankle sprain resulted from a sudden increase in ankle inversion accompanied by internal rotation.However,without sufficient ankle kinetics and muscle activity information in the literature,the detailed mechanism of ankle sprain is still unrevealed.The purpose of our case report is to present 2 accidental ankle giving way incidents for participants with chronic ankle instability(CAI)and compare to their normal trials with data of kinematics,kinetics,and electromyography(EMG).Case description:Two young female participants accidentally experienced the ankle giving way when landing on a 25°lateral-tilted force plate.3 D kinematics,kinetics,and muscle activity were recorded for the lower extremity.Qualitative comparisons were made between the giving way trials and normal trials for joint angles,angular velocities,moments,centers of pressure and EMG linear envelopes.Results:One participant’s giving way trial displayed increased ankle inversion and internal rotation angles in the pre-landing phase and at initial contact compared to her normal trials.Another participant’s giving way trial exhibited greater hip abduction angles and delayed activation of the peroneus longus muscle in the pre-landing phase versus her normal trials.Conclusion:A vulnerable ankle position(i.e.,more inverted and internally rotated),and a late activation of peroneus activity in the pre-landing phase could result in the ankle giving way or even sprains.A neutral ankle position and early activation of ankle evertors before landing may be helpful in preventing ankle sprains.展开更多
Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a...Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.展开更多
Background:Stochastic resonance stimulation(SRS) transmits subsensory electrical Gaussian white noise into the body to enhance sensorimotor function.This therapy has improved static single leg balance in subjects with...Background:Stochastic resonance stimulation(SRS) transmits subsensory electrical Gaussian white noise into the body to enhance sensorimotor function.This therapy has improved static single leg balance in subjects with functional ankle instability.However,the effect of this stimulation on dynamic single leg balance is not known.Improvements in dynamic single leg balance with SRS may have implications For enhancing functional rehabilitation for ankle instability.Thus,the purpose of this study was to determine the effects of SRS on dynamic single leg balance in subjects with functional ankle instability. Methods:This study was an experimental research design and data were collected in a sports medicine research laboratory.Twelve subjects with functional ankle instability(69±15 kg;173±10 cm;21±2 years) reported a history of ankle sprains and instability at the ankle with physical activity.A single leg jump-landing test was used to assess dynamic balance.Subjects were required to jump between 50% and 55% of the maximal vertical jump height,land on a single leg atop a force plate,and stabilize as quickly as possible.Jump-landing tests were performed with and without SRS.Three trials were performed for each treatment condition(SRS and control).A randomized block design was used to determine test order.Anterior/posterior and medial/lateral time-to-stabilization were computed to assess dynamic balance.Lesser time indicated better stability.One-tailed paired samples t tests were used for analysis(α≤0.05). Results:SRS improved anterior/posterior time-to-stabilization(stochastic resonance = 1.32±0.31 s,control = 1.74±0.80 s,p = 0.03),but did not enhance medial/lateral time-to-stabilization(stochastic resonance = 1.95±0.40 s,control = 1.92±0.48 s,p = 0.07). Conclusion:Clinicians might use SRS to facilitate balance improvements with sagittal plane dynamic single leg balance exercises that patients may not be able to perform otherwise.展开更多
Lateral ankle instability is one of the most common and well-recognized conditions presenting to foot and ankle surgeons.It may exist as an isolated entity or in conjunction with other concomitant pathology,making it ...Lateral ankle instability is one of the most common and well-recognized conditions presenting to foot and ankle surgeons.It may exist as an isolated entity or in conjunction with other concomitant pathology,making it important to appropriately diagnose and identify other conditions that may need to be addressed as part of treatment.These associated conditions may be a source of chronic pain,even when the instability has been appropriately treated,or may lead to failure of treatment by predisposing the patient to ankle inversion injuries.The primary goal of this editorial is to provide a brief summary of the common techniques used in the delayed reconstruction of lateral ankle ligamentous injuries and present a method we have successfully employed for over 15 years.We will also briefly discuss the diagnosis and treatment of the more common associated conditions,which are important to identify to achieve satisfactory results for the patient.We present the outcomes of 250 consecutive reconstructions performed over the last 10 years and describe our operative technique for addressing lateral ankle ligamentous injuries.展开更多
Background:The Identification of Functional Ankle Instability(IdFAI)is a valid and reliable tool to identify chronic ankle instability;however,it was developed in English,thus limiting its usage only to those who can ...Background:The Identification of Functional Ankle Instability(IdFAI)is a valid and reliable tool to identify chronic ankle instability;however,it was developed in English,thus limiting its usage only to those who can read and write in English.The objectives of our study were to(1)cross-culturally adapt a Chinese(Mandarin)version of the IdFAI and(2)determine the psychometric properties of the Chinese version IdFAI.Methods:The cross-cultural adaptation procedures used by the investigators and translators followed previously published guidelines and included 6 stages:(1)initial translation,(2)synthesis of the translations,(3)back translation,(4)developing the pre-final version for field testing,(5)testing the pre-final version,and(6)finalizing the Chinese version of IdFAI(IdFAI-C).Five psychometric properties of the IdFAI-C were assessed from results of 2 participant groups:bilingual(n=20)and Chinese(n=625).Results:A high degree of agreement was found between the English version of IdFAI and IdFAI-C(intra-class correlation_(2,1)=0.995).An excellent internal consistency(Cronbach'sα=0.89),test—retest reliability(intra-class correlation_(2,1)=0.970),and construct validity(r(625)=0.67)was also found for the IdFAI-C.In addition,the results of exploratory and confirmatory factor analysis indicated that ankle instability was the only construct measured from the IdFAI.Conclusion:The IdFAI-C is a highly reliable and valid self-report questionnaire that can be used to assess ankle instability.Therefore,we suggest that it can be used to effectively and accurately assess chronic ankle instability in clinical settings for Chinese-speaking individuals.展开更多
In the present paper,70 cases of acute sprain of soft tissue were treated withacupuncture at pressure pain points on the lateral of the second metacarpal bone.Results showedthat the cure rate was 58.6% and the total ...In the present paper,70 cases of acute sprain of soft tissue were treated withacupuncture at pressure pain points on the lateral of the second metacarpal bone.Results showedthat the cure rate was 58.6% and the total effective rate was 94.3%.Also,its mechanisms werestudied preliminarily.The present therapy is simple,convenient,easy to operate and it producesrapidly desired effects with a higher cure rate,so it is suited to be popularized clinically.展开更多
In the present paper,30 cases of acute lumbar sprain are treated with finger pressuretherapy and moxibustion therapy.Results show that 21 cases are cured,4 markedly effective and 5effctive.This combined treatment has ...In the present paper,30 cases of acute lumbar sprain are treated with finger pressuretherapy and moxibustion therapy.Results show that 21 cases are cured,4 markedly effective and 5effctive.This combined treatment has no sufferings to the patient,is safe,simple and easy to be ac-cepted by patients.展开更多
Background:Lateral ankle sprain is the most common musculoskeletal injury.Although clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to transla...Background:Lateral ankle sprain is the most common musculoskeletal injury.Although clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to translate into patient benefits.Methods:We audited 30 years of experimental research related to lateral ankle sprain management(n=74 randomized controlled trials)to determine if reports of treatment effectiveness could be validated beyond statistical certainty.Results:A total of 77%of trials reported positive treatment effects,but there was a high risk of false discovery.Most trials were unregistered and relied solely on statistical significance,or lack of statistical significance,rather than on interpreting key measures of minimum clinical importance(e.g.,minimal detectable change,minimal clinically important difference).Conclusion:Future clinical trials must adopt higher standards of reporting and data interpretation.This includes consideration of the ethical responsibility to preregister their research and interpretation of clinical outcomes beyond statistical significance.展开更多
Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral...Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral ankle sprain copers,and healthy controls.Methods:Twenty-three participants with CAI,23 lateral ankle sprain copers,and 24 healthy control participants volunteered.Active motor threshold(AMT),normalized motor-evoked potential(MEP),and cortical silent period(CSP)were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.Results:Participants with CAI had significantly longer CSP at 100%of AMT and lower normalized MEP at 120%of AMT compared to lateral ankle sprain copers(CSP100%:p=0.003;MEP120%:p=0.044)and controls(CSP100%:p=0.041;MEP120%:p=0.006).Conclusion:This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI.Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.展开更多
Ankle injuries are commonplace in the athletic population, with lateral ligamentsprains accounting for the majority of them. The medial ligament complex, thedistal tibiofibular syndesmosis as well as any of the bones ...Ankle injuries are commonplace in the athletic population, with lateral ligamentsprains accounting for the majority of them. The medial ligament complex, thedistal tibiofibular syndesmosis as well as any of the bones that constitute the anklejoint can also be injured. Typical mechanisms of injury include inversion-plantarflexionand external rotation on a supinated, dorsiflexed or pronated foot. Lesionsof the ankle present with similar symptoms of pain, swelling and tenderness.Therefore, a thorough history and physical examination must be obtained to makethe correct diagnosis. This is especially critical for athletes as certain injuries canlead to termination of their career if not treated accurately on time. Imaging maybe useful in some cases to confirm or rule out differential diagnoses. Most injuriescan be managed conservatively using the Protection, Rest, Ice, Compression andElevation protocol followed by a comprehensive rehabilitation programme.Surgery is reserved for grade III ligament tears that are refractory to initial nonoperativetreatment and displaced fractures that are unlikely to unite withoutsurgical intervention. The objective of this review is to discuss the common ankleinjuries encountered in the athletic population and the approaches to theirdiagnosis and management.展开更多
Acute waist sprain is a local injury of themuscle, fascia and ligament in the waist due tosudden overstretch by external force beyond thenormal physiological limit. Acute waist spraincan lead to cicatrix adhesion, los...Acute waist sprain is a local injury of themuscle, fascia and ligament in the waist due tosudden overstretch by external force beyond thenormal physiological limit. Acute waist spraincan lead to cicatrix adhesion, loss of normal tis-sue function and chronic waist pathologicalchanges without timely and effecthe treatment.Long time treatment without cure will affectboth work and daily life.展开更多
文摘BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the modern cast.The Opencast®is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related complications.Although this novel cast appears to have more benefits than the conventional synthetic cast,its clinical efficacy and advantages have not been established.AIM To investigate the clinical efficacy and advantages of the newly developed Opencast®based on patients’perspectives in those with ankle inversion injury.METHODS A specifically designed questionnaire consisting of 19 items was used to compare patients’opinions and concerns of the Opencast®and the conventional synthetic cast.The items were focused on subjective patient satisfaction,discomfort,and adverse effects while wearing the cast.Patients with an ankle inversion injury diagnosed as a high-grade ankle sprain were enrolled.The subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast®for 2 wk.They were then required to fill the questionnaire again,after switching to the alternative type of cast for 2 more weeks.RESULTS A total of 22 subjects participated in the study.The synthetic cast appeared to be more rigid and stable than the Opencast®,but there was no significant difference in the amount of pain relief.The likelihood of adverse effects when wearing the synthetic cast was significantly higher.Patient satisfaction tended to be rated higher after wearing the Opencast®.Opencast®showed more subjective vulnerability than the synthetic cast,but there was no significant difference in the redo rate.Patients were more anxious about removal of the synthetic cast than of the Opencast®.CONCLUSION The results indicate that the Opencast®could replace the conventional synthetic cast as it offers increased patient satisfaction,which would in turn increase compliance to treatment.
文摘Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The present paper examines some subjects with a previous history of acute inversion ankle sprain who have developed a subsequent condition of instability, grouping them according to inclusion criteria and analyzing them through four field tests considered objective by the scientific literature: SEBT test, BEES test, TIBT test, SHT test. The data obtained were stored in order to compare them following a re-education protocol aimed at improving proprioception, balance, walking and strengthening the extrinsic and intrinsic muscles of the foot. per year. The subjects were then divided into two categories: subjects with CAI > 1 year and subjects with CAI ≤ 1 year. A protocol lasting 6 weeks was administered to both groups, trying to work on improving balance in single stance, improving static and dynamic stability, strengthening the gluteus medius and maximus (pelvis stabilizers) and strengthening of the intrinsic muscles of the foot. At the end of the protocol the subjects were all re-evaluated with the same field tests used previously and the data obtained were compared both with the pre-protocol data and with the data measured by the control subjects.
文摘BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.
基金supported by the Biomedicine Supporting Program of Shanghai "Science and Technology Innovation Plan" (19441902400)the Ningxia Hui Autonomous Region Key R&D program (2020BCH01001)+1 种基金the Shanghai "Science and Technology Innovation Action Plan" Domestic Science and Technology Cooperation Project (20025800200)the Clinical Research Program of Shanghai Municipal Health Commission (201940367)。
文摘Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial risk for developing CAI.This study identifies magnetic resonance imaging(MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.Methods:All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1,2017 to December 1,2019 were identified.Data were collected using the Cumberland Ankle Instability Tool at final follow-up.Demographic and other related clinical variables,including age,sex,body mass index,and treatment were also recorded.Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.Results:A total 131 out of 362 patients with a mean follow-up of 3.0± 0.6 years(mean ± SD;2.0—4.1 years) developed CAI after first-episode LAS.According to multivariable regression,development of CAI after first-episode LAS was associated with 5 prognostic factors:age(odds ratio(OR)=0.96,95% confidence interval(95%CI):0.93-1.00,p=0.032);body mass index(OR=1.09,95%CI:1.02-1.17,p=0.009);posterior talofibular ligament injury(OR=2.17,95%CI:1.05-4.48,p=0.035);large bone marrow lesion of the talus(OR=2.69,95%CI:1.30-5.58,p=0.008),and Grade 2 effusion of the tibiotalar joint(OR=2.61,95%CI:1.39-4.89,p=0.003).When patients had at least 1 positive clinical finding in the 10-m walk test,anterior drawer test,or inversion tilt test,they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.Conclusion:MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the10-m walk test,anterior drawer test,and inversion tilt test.Further prospective and large-scale studies are necessary for validation.
文摘Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.
基金supported in part by DeRoyal Industries, Inc.,Powell,TN,USA
文摘Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace(Element<sup>TM</sup>) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces(GRFs) during a drop landing activity in subjects with chronic ankle instability(CAD compared to healthy subjects with no history of CAI. Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects, respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace(NB).Element<sup>? </sup>brace and ASO brace.Simultaneous recording of three-dimensional kinematic(240 Hz) and GRF(1200 Hz) data were performed. Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of Element<sup>TM</sup> against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy controls.The ASO brace reduced the first peak vertical GRF whereas Element<sup>TM</sup> increased 2nd peak vertical GRF. Element<sup>TM</sup>brace reduced eversion range of motion(ROM) and peak eversion velocity compared to NB and ASO.In addition,Element<sup>TM</sup> reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO. Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for Element<sup>TM</sup>.
文摘Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains affect the lateral ligaments,particularly the anterior talofibular ligament.Despite its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic cornerstones.Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules.Several interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.An exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific exercises.Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance testing.There are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and avoid.These include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate rehabilitation.The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.
基金supported by a Ph.D.scholarship from Najran University in Najran,Saudi Arabia
文摘Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclusion criteria for CAL We investigated the prevalence of pain inpeople with CAI and the association between presence of pain and other CAI characteristics.Methods'. Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that usedthe Cumberland Ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland Ankle Instability Tool, whichasks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physicalactivities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteris・tics was analyzed by /2 tests and factors associated with each pain category were analyzed by logistic regression.Results'. Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities,47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong associationbetween ankle instability and ankle pain (/2 = 122.2, p < 0.001, OR = 53& 95% confidence interval (CI): 3.84—7.53). Perceived ankle instability,age and unilateral ankle sprains were independently associated with pain (ankle instability: /2 = 43.29, p < 0.001;age: /2 = 30.37,p < 0.001;unilateral ankle sprains: /2 = 6.25, p < 0.05). There was no significant difference in the presence of pain between genders.Conclusion-. The prevalence of pain in people with CAI was high and was related to perceived ankle instability. Number of sprains, age, genderand unilateral or bilateral sprain did not modify this result except for the first pain category (pain during daily activities). There is large gap incurrent knowledge about the impact of pain in people with CAI, and this topic needs further investigation.
文摘Background:Several case studies observed that the lateral ankle sprain resulted from a sudden increase in ankle inversion accompanied by internal rotation.However,without sufficient ankle kinetics and muscle activity information in the literature,the detailed mechanism of ankle sprain is still unrevealed.The purpose of our case report is to present 2 accidental ankle giving way incidents for participants with chronic ankle instability(CAI)and compare to their normal trials with data of kinematics,kinetics,and electromyography(EMG).Case description:Two young female participants accidentally experienced the ankle giving way when landing on a 25°lateral-tilted force plate.3 D kinematics,kinetics,and muscle activity were recorded for the lower extremity.Qualitative comparisons were made between the giving way trials and normal trials for joint angles,angular velocities,moments,centers of pressure and EMG linear envelopes.Results:One participant’s giving way trial displayed increased ankle inversion and internal rotation angles in the pre-landing phase and at initial contact compared to her normal trials.Another participant’s giving way trial exhibited greater hip abduction angles and delayed activation of the peroneus longus muscle in the pre-landing phase versus her normal trials.Conclusion:A vulnerable ankle position(i.e.,more inverted and internally rotated),and a late activation of peroneus activity in the pre-landing phase could result in the ankle giving way or even sprains.A neutral ankle position and early activation of ankle evertors before landing may be helpful in preventing ankle sprains.
文摘Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.
文摘Background:Stochastic resonance stimulation(SRS) transmits subsensory electrical Gaussian white noise into the body to enhance sensorimotor function.This therapy has improved static single leg balance in subjects with functional ankle instability.However,the effect of this stimulation on dynamic single leg balance is not known.Improvements in dynamic single leg balance with SRS may have implications For enhancing functional rehabilitation for ankle instability.Thus,the purpose of this study was to determine the effects of SRS on dynamic single leg balance in subjects with functional ankle instability. Methods:This study was an experimental research design and data were collected in a sports medicine research laboratory.Twelve subjects with functional ankle instability(69±15 kg;173±10 cm;21±2 years) reported a history of ankle sprains and instability at the ankle with physical activity.A single leg jump-landing test was used to assess dynamic balance.Subjects were required to jump between 50% and 55% of the maximal vertical jump height,land on a single leg atop a force plate,and stabilize as quickly as possible.Jump-landing tests were performed with and without SRS.Three trials were performed for each treatment condition(SRS and control).A randomized block design was used to determine test order.Anterior/posterior and medial/lateral time-to-stabilization were computed to assess dynamic balance.Lesser time indicated better stability.One-tailed paired samples t tests were used for analysis(α≤0.05). Results:SRS improved anterior/posterior time-to-stabilization(stochastic resonance = 1.32±0.31 s,control = 1.74±0.80 s,p = 0.03),but did not enhance medial/lateral time-to-stabilization(stochastic resonance = 1.95±0.40 s,control = 1.92±0.48 s,p = 0.07). Conclusion:Clinicians might use SRS to facilitate balance improvements with sagittal plane dynamic single leg balance exercises that patients may not be able to perform otherwise.
文摘Lateral ankle instability is one of the most common and well-recognized conditions presenting to foot and ankle surgeons.It may exist as an isolated entity or in conjunction with other concomitant pathology,making it important to appropriately diagnose and identify other conditions that may need to be addressed as part of treatment.These associated conditions may be a source of chronic pain,even when the instability has been appropriately treated,or may lead to failure of treatment by predisposing the patient to ankle inversion injuries.The primary goal of this editorial is to provide a brief summary of the common techniques used in the delayed reconstruction of lateral ankle ligamentous injuries and present a method we have successfully employed for over 15 years.We will also briefly discuss the diagnosis and treatment of the more common associated conditions,which are important to identify to achieve satisfactory results for the patient.We present the outcomes of 250 consecutive reconstructions performed over the last 10 years and describe our operative technique for addressing lateral ankle ligamentous injuries.
文摘Background:The Identification of Functional Ankle Instability(IdFAI)is a valid and reliable tool to identify chronic ankle instability;however,it was developed in English,thus limiting its usage only to those who can read and write in English.The objectives of our study were to(1)cross-culturally adapt a Chinese(Mandarin)version of the IdFAI and(2)determine the psychometric properties of the Chinese version IdFAI.Methods:The cross-cultural adaptation procedures used by the investigators and translators followed previously published guidelines and included 6 stages:(1)initial translation,(2)synthesis of the translations,(3)back translation,(4)developing the pre-final version for field testing,(5)testing the pre-final version,and(6)finalizing the Chinese version of IdFAI(IdFAI-C).Five psychometric properties of the IdFAI-C were assessed from results of 2 participant groups:bilingual(n=20)and Chinese(n=625).Results:A high degree of agreement was found between the English version of IdFAI and IdFAI-C(intra-class correlation_(2,1)=0.995).An excellent internal consistency(Cronbach'sα=0.89),test—retest reliability(intra-class correlation_(2,1)=0.970),and construct validity(r(625)=0.67)was also found for the IdFAI-C.In addition,the results of exploratory and confirmatory factor analysis indicated that ankle instability was the only construct measured from the IdFAI.Conclusion:The IdFAI-C is a highly reliable and valid self-report questionnaire that can be used to assess ankle instability.Therefore,we suggest that it can be used to effectively and accurately assess chronic ankle instability in clinical settings for Chinese-speaking individuals.
文摘In the present paper,70 cases of acute sprain of soft tissue were treated withacupuncture at pressure pain points on the lateral of the second metacarpal bone.Results showedthat the cure rate was 58.6% and the total effective rate was 94.3%.Also,its mechanisms werestudied preliminarily.The present therapy is simple,convenient,easy to operate and it producesrapidly desired effects with a higher cure rate,so it is suited to be popularized clinically.
文摘In the present paper,30 cases of acute lumbar sprain are treated with finger pressuretherapy and moxibustion therapy.Results show that 21 cases are cured,4 markedly effective and 5effctive.This combined treatment has no sufferings to the patient,is safe,simple and easy to be ac-cepted by patients.
文摘Background:Lateral ankle sprain is the most common musculoskeletal injury.Although clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to translate into patient benefits.Methods:We audited 30 years of experimental research related to lateral ankle sprain management(n=74 randomized controlled trials)to determine if reports of treatment effectiveness could be validated beyond statistical certainty.Results:A total of 77%of trials reported positive treatment effects,but there was a high risk of false discovery.Most trials were unregistered and relied solely on statistical significance,or lack of statistical significance,rather than on interpreting key measures of minimum clinical importance(e.g.,minimal detectable change,minimal clinically important difference).Conclusion:Future clinical trials must adopt higher standards of reporting and data interpretation.This includes consideration of the ethical responsibility to preregister their research and interpretation of clinical outcomes beyond statistical significance.
文摘Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral ankle sprain copers,and healthy controls.Methods:Twenty-three participants with CAI,23 lateral ankle sprain copers,and 24 healthy control participants volunteered.Active motor threshold(AMT),normalized motor-evoked potential(MEP),and cortical silent period(CSP)were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.Results:Participants with CAI had significantly longer CSP at 100%of AMT and lower normalized MEP at 120%of AMT compared to lateral ankle sprain copers(CSP100%:p=0.003;MEP120%:p=0.044)and controls(CSP100%:p=0.041;MEP120%:p=0.006).Conclusion:This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI.Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.
文摘Ankle injuries are commonplace in the athletic population, with lateral ligamentsprains accounting for the majority of them. The medial ligament complex, thedistal tibiofibular syndesmosis as well as any of the bones that constitute the anklejoint can also be injured. Typical mechanisms of injury include inversion-plantarflexionand external rotation on a supinated, dorsiflexed or pronated foot. Lesionsof the ankle present with similar symptoms of pain, swelling and tenderness.Therefore, a thorough history and physical examination must be obtained to makethe correct diagnosis. This is especially critical for athletes as certain injuries canlead to termination of their career if not treated accurately on time. Imaging maybe useful in some cases to confirm or rule out differential diagnoses. Most injuriescan be managed conservatively using the Protection, Rest, Ice, Compression andElevation protocol followed by a comprehensive rehabilitation programme.Surgery is reserved for grade III ligament tears that are refractory to initial nonoperativetreatment and displaced fractures that are unlikely to unite withoutsurgical intervention. The objective of this review is to discuss the common ankleinjuries encountered in the athletic population and the approaches to theirdiagnosis and management.
文摘Acute waist sprain is a local injury of themuscle, fascia and ligament in the waist due tosudden overstretch by external force beyond thenormal physiological limit. Acute waist spraincan lead to cicatrix adhesion, loss of normal tis-sue function and chronic waist pathologicalchanges without timely and effecthe treatment.Long time treatment without cure will affectboth work and daily life.