Football injuries of the ankle: A review of injury mechanisms, diagnosis and management

Football is the most popular sport worldwide and is associated with a high injury rate, most of which are the result of trauma from player contact. Ankle injuries are among the most commonly diagnosed injuries in the game. The result is reduced physical activity and endurance levels, lost game time, and considerable medical cost. Sports medicine professionals must employ the correct diagnostic tools and effective treatments and rehabilitation protocols to minimize the impact of these injuries on the player. This review examines the diagnosis, treatment, and postoperative rehabilitation for common football injuries of the ankle based on the clinical evidence provided in the current literature.

Acute syndesmotic injuries in ankle fractures:From diagnosis to treatment and current concepts

A stable and precise articulation of the distal tibiofibular syndesmosis maintains the tibiofibular relationship,and it is essential for normal motion of the ankle joint.The disruption of this joint is frequently accompanied by rotational ankle fracture,such as pronation-external rotation,and rarely occurs without ankle fracture.The diagnosis is not simple,and ideal management of the various presentations of syndesmotic injury remains controversial to this day.Anatomical restoration and stabilization of the disrupted tibiofibular syndesmosis is essential to improve functional outcomes.In such an injury,including inadequately treated,misdiagnosed and correctly diagnosed cases,a chronic pattern characterized by persistent ankle pain,function disability and early osteoarthritis can result.This paper reviews anatomical and biomechanical characteristics of this syndesmosis,the mechanism of its acute injury associated to fractures,radiological and arthroscopic diagnosis and surgical treatment.

What priorities should be considered for Iranian veterans with ankle-foot injuries？ A health needs assessment study, 25 years post-conflict

Despite the passage of time,a large number of veterans are still affected by injuries acquired during Iran-Iraq war.In addition to their primary injuries,the majority of veterans also experience difficulty with long-term,secondary effects.Studies have shown that the most common of these include a range of disabilities,pain,and dramatic decline in mental health and quality of life.Improving living conditions and providing rehabilitation services to veterans has always been a main priority of authorities.The goal of this study was to explain the methods and materials with which these priorities were explored.

Application Effect of Chinese Medicine Rehabilitation in the Treatment of Adolescent Ankle Sports Injuries

Objective:To analyze the clinical effect of traditional Chinese medicine rehabilitation in treating adolescent ankle sports injuries.Methods:From December 2020 to December 2022,adolescent patients with ankle joint sports injuries admitted to our hospital were selected as observation objects,and 67 patients were divided into a control group(n=33,routine rehabilitation treatment)and an experimental group(n=34,traditional Chinese medicine rehabilitation treatment)according to the computer grouping method.Compare the treatment results.Results:(i)The treatment received in the experimental group had an efficacy of 94.11%,which was higher than that of the control group(75.75%),and statistical significance was established(P<0.05).(ii)Before treatment,there was no difference in ankle joint pain,ankle joint activity,and ankle joint function scores between the control group and the experimental group(P>0.05);after treatment,the ankle joint pain,ankle joint activity,and ankle joint function scores in the experimental group were significantly higher than those in the control group(P<0.05).(iii)The experimental group had higher scores on physiological function,physiological function,physical pain,general health status,energy,social function,emotional function,and mental health compared to the control group(P<0.05).Conclusion:Traditional Chinese medicine rehabilitation is effective in treating ankle injuries caused by sports in adolescents and improve their quality of life.Therefore,it should be popularized.

Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery

Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Pa- tients received oral vitamin B^2 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory func- tion in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months.

Chronic Ankle Instability: Therapeutic Exercise and Data Analysis

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.

Surface Electromyographic Study of Peroneus Longus Activation during Ankle Eversion and Heel Lift

Prophylactic and rehabilitative ankle training programs rarely incorporate ankle eversion exercises of the weight bearing leg during one-legged stand. Such training may be necessary for the optimal PL function and dynamic ankle control. In this study, we compared a PL exercise that involved eversion of the inverted ankle of a weight bearing leg against the heel lift (HL), a popular PL strengthening exercise. The PL activation patterns were studied in 20 university students (7 male and 13 female). The self-reported dominant legs of the subjects were tested in this study. After recording the surface electromyographic (EMG) activity level of their PL maximal voluntary isometric contractions (MVIC), the subjects performed HL, and ankle eversions of the weight bearing ankle during one-legged stand. Ankle eversions were initiated from two inverted ankle positions, 20 degree inversion (EV1) and 25 degree inversion (EV2). The ankle position and the PL muscle activity were recorded with an accelerometer affixed to the dorsum of the foot and a surface EMG electrode over PL respectively. The ranges of motion for HL, EV1, and EV2 were 25, 29, and 31 degrees respectively. Expressed as percentage of MVIC, the average normalized EMG linear envelopes for EV1 (73%) and EV2 (74%) were significantly greater than HL (64%). These results demonstrated that eversions of the inverted ankle of the weight bearing leg elicited stronger PL activation that may result in better lateral ankle strength and dynamic control. Incorporation of weight bearing ankle eversions may enhance effectiveness of PL exercise and balance.

Management of syndesmotic injuries:What is the evidence?

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.

Acute ankle sprain in athletes:Clinical aspects and algorithmic approach

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.

A lateral ankle sprain during a lateral backward step in badminton:A case report of a televised injury incident

Background:This study presents a kinematic analysis of an acute lateral ankle sprain incurred during a televised badminton match.The kinematics of this injury were compared to those of 19 previously reported cases in the published literature.Methods:Four camera views of an acute lateral ankle sprain incurred during a televised badminton match were synchronized and rendered in3-dimensional animation software.A badminton court with known dimensions was built in a virtual environment,and a skeletal model scaled to the inj ured athlete’s height was used for skeletal matching.The ankle joint angle and angular velocity profiles of this acute injury were compared to the summarized findings from 19 previously reported cases in the published literature.Results:At foot strike,the ankle joint was 2° everted,33° plantarflexed,and 18° internally rotated.Maximum inversion of 114° and internal rotation of 69° was achieved at 0.24 s and 0.20 s after foot strike,respectively.After the foot strike,the ankle joint moved from an initial position of plantarflexion to dorsiflexion-from 33° plantarflexion to 53° dorsiflexion(range=86°).Maximum inversion,dorsiflexion,and internal rotation angular velocity were 1262°/s,961°/s,and 677°/s,respectively,at 0.12 s after foot strike.Conclusion:A forefoot landing posture with a plantarflexed and internally rotated ankle joint configuration could incite an acute lateral ankle sprain injury in badminton.Prevention of lateral ankle sprains in badminton should focus on the control and stability of the ankle joint angle during forefoot landings,especially when the athletes perform a combined lateral and backward step.

ACUPUNCTURE TREATMENT FOR SPRAINS OF THE ANKLE JOINT IN 354 CASES

Sprains of the ankle joint is one of themost common soft tissue injuries,which isusually caused by a violent twisting.Thismovement can lacerate the interarticular lig-aments and the tendon insertions aroundthe ankle joint.We treated 354 cases of thistype of injury with acupuncture,yielding aninspiring therapeutic result.CLINICAL MATERIALSOf the 354 cases in this series,291 caseswere injured for the first time,and 63

Injuries in Spanish female soccer players

Background: Epidemiologic research to learn the incidence, type, location, and severity of female soccer injuries and the risk factors for sustaining a sport injury is the first step in developing preventive policies. The aim of this study was to analyze the incidence of injuries in the population of female soccer players in Spain.Methods: The injuries incurred by 25,397 female soccer players were registered by the medical staff of the Spanish Football Federation during 1 season. A standardized medical questionnaire was used to classify the injury according to type, severity, location, and injury mechanism. A total of 2108 injuries was reported with an incidence of 0.083 injuries per player per season. Most injuries were in the lower limbs(74.0%), mainly affecting knee(30.4%) and ankle joints(17.9%).Results: The proportion of injuries derived from contact with another player was higher during matches(33.7%) than during training(11.4%;p < 0.001). Noncontact injuries were classified as severe more frequently than were contact injuries(51.0% vs. 42.6%; p < 0.001). A higher incidence of injury was found in adult soccer players(≥18 years) vs. their counterparts younger than 18 years(0.094 vs. 0.072 injuries per player per year, respectively; p < 0.001). There were no differences between age groups in any other injury variable(e.g., type, mechanism, location, or severity; p > 0.05).Conclusion: Most female soccer injuries were located at the knee and ankle; the injury mechanism determined the playing time lost; and the player's age did not affect injury characteristics.

Ankle Arthroscopy: A Complimentary Adjunct in the Diagnosis and Management of Ankle Fractures

Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may arise as a result of untreated ligamentous or chondral injuries. This study aims to correlate acute arthroscopic ankle findings with the Lauge-Hansen fracture pattern classification. We further aim to compare subjective functional outcomes at least one year following surgery between patients who have received Open Reduction and Internal Fixation (ORIF) alone, versus ORIF plus arthroscopy. This is a retrospective case series of patients who have undergone ankle fracture ORIF +/- arthroscopy from July 2014 to July 2017 inclusive. Each patient’s presenting radiograph was classified according to the Lauge-Hansen ankle fracture classification with subsequent correlation to intra-operative arthroscopic findings. Functional outcome at a minimum of one year was evaluated with the American Academy of Orthopaedic Surgeons (AAOS) metric. Twenty two patients underwent ankle ORIF plus arthroscopy (Group A) with a further 26 patients receiving ORIF alone (Group B). 1 in 3 supination-external-rotation type II (SER II) injuries possessed a concomitant syndesmosis injury or osteochondral lesion (OCL) on arthroscopy. 1 in 3 patients with an SER IV injury had an osteochondral lesion. The mean AAOS score achieved for Group A was 89.6 (±7.9) with the mean score for Group B being 82.0 (±13.7). In conclusion, ankle arthroscopy aids the diagnosis and treatment of ligamentous and osteochondral injuries not evident on plain film with subsequent superior short-term outcomes.

Health-related quality of life and the ability to perform activities of daily living: a cross-sectional study on 1079 war veterans with ankle-foot disorders

Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime.This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.Methods:A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016.Demographic characteristics,including age,gender,marital status,disability percent,educational level,employment and additional injuries,were collected.The ability to perform daily activities was assessed using the Barthel activities of daily living(ADL)and Lawton instrumental activities of daily living(IADL)Indexes.Physical and mental health-related quality of life(HRQOL)data were measured via the SF-36 subscales.The data were compared with those of bilateral lower limb amputees(BLLAs)and of the general Iranian population.Statistical analyses,including Pearson’s correlation coefficient,one-sample t-test and analysis of variance(ANOVA),were performed using SPSS16.0.A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary(PCS)and Mental Component Summary(MCS).Results:The highest and lowest scores were observed for mental health(48.93±20.69)and bodily pain(28.16±21.74),respectively.The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees(P<0.001).The mean scores of ADLs and IADLs were 83.9±16.3 and 5.3±2.0,respectively.The higher dependency in ADLs(P<0.001)and IADLs(P<0.001),the higher disability rate(P<0.001)and additional injury(P<0.001)were significant determinants of the PCS.ADL(P<0.001)and IADL(P<0.001)limitations,additional injury(P<0.001),history of hospitalization in the year preceding the study(P=0.007)and employment(P=0.001)were reported as determinants of the MCS.Conclusion:The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor healthrelated quality of life.The main predicting factors of HRQOL were the disability to perform ADLs/IADLs,suffering two or more injuries,a history of hospitalization in the year preceding the study and unemployment.

Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with type 2 diabetes

The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

Assessment of orthotic needs in Iranian veterans with ankle and foot disorders

Background: War-related traumas can lead to orthopedic and neurological disorders in victims. However, the scope of such disorders may expand months or even years after the trauma. Orthotic treatment as a rehabilitation process aims to enable people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels. This study aimed to investigate the rate of using orthoses among Iranian veterans with neuromuscular and skeletal disorders of the ankle and foot. Furthermore, the priorities of orthotic treatment in those veterans were explored.Methods: This qualitative study was a national health needs assessment conducted in 11 provinces of Iran during 2011–2016. A stakeholder research group was established to survey the veterans in respect to their demographic variables, activities of daily living, current health conditions, and rate of using orthoses.Results: Overall, 907 of the 1124 veteran participants completed the survey(response rate: 80.7%). Most of the veterans were men(97.7%), and their age and disability rate were 52.07±8.13 years and 31.92%±14.93%, respectively. Nearly 42% of the veterans had experience in using orthoses on a daily and weekly basis. As physical ambulation was the main problematic activity in veterans, most of them were using medical shoes and foot orthoses. Nearly 37% of veterans were in need of some type of lower limb orthoses on the contralateral side to compensate for their hip inequality. In sequential order, the most in need orthoses for veterans were foot orthoses(n=538), medical shoes(n=447), lower limb orthoses on the contralateral side(n=320), spinal orthoses(n=273), and upper limb orthoses(n=86).Conclusion: In spite of the high demands for orthoses among Iranian veterans with ankle and foot disorders, the use of orthoses is insufficient. Hence, there is a discrepancy between the current rate of orthoses use and its ideal situation, and more resources should be provided for service providers to be able to serve veterans. Moreover, veterans should be educated regarding orthoses, their use, and their impacts on the user's health status. The findings of a needs assessment of orthoses can be used in strategic planning and decision making to improve health care services for Iranian veterans.

Functional Ankle Instability Prevalence and Associated Risk Factors in Male Football Players

Background: The injuries sustained in football most frequently occur to the lower extremity, with ankle and knee being the most affected joint segments. Many studies have defined ankle sprain as one of the most common sports injuries with an annual incidence rate of 15% to 45%, however, there’s a lack of studies in football regional leagues. Risk factors like anthropometric measures, field position, dominant limb, previous injury have been described as being associated with ankle injuries in the elite sports context. The primary aim of this study was to determine prevalence rates of self-reported ankle instability in regional leagues. A secondary aim was to explore the presence of extrinsic factors affecting ankle instability in these football players. Methods: The heads of all clubs (n = 66) from Coimbra and Aveiro (Portugal) regional male senior football divisions during season 2016/2017 were contacted by e-mail or telephone to enter the study, and 58 gave their permission to include their athletes. Then, all players from each of these 58 teams were invited to enter the study (n = 1044) and a total of 589 athletes participated. Demographic and anthropometric data were recorded concerning age, height, weight, years of training, mean number of training hours, position in camp along with specific questions related to an ankle injury. All participants were asked about their previous history of injury, reinjury, feeling of giving-away and where also asked to fill the Cumberland Ankle Instability Tool. Results: A total of 290 (49.2%) athletes reported a history of at least one previous sprain and, from these, 170 (58.6%) repeated the injury and 112 (19%) reported sensation of “giving-away”. A significant association was found between injury, recurrence and subjective feeling of giving away (p < 0.05). The player field’s position was found to be associated with ankle instability, with defenders and forwards having higher rates of self-reported instability. No other significant associations were found. Conclusion: Along with intrinsic factors (age and injury repetition), some extrinsic factors were found to be associated with instability rates in professional regional football players (exposure time, and position on the field) suggesting the need for specific prevention strategies.

Fibula pro-tibia vs standard locking plate fixation in an ankle fracture saw bone model

BACKGROUND Locking plate fixation in osteoporotic ankle fractures may fail due to cut-out or metalwork failure.Fibula pro-tibia fixation was a technique prior to the advent of locking plates that was used to enhance stability in ankle fractures by achieving tri or tetra-cortical fixation.With locking plates,the strength of this fixation construct can be further enhanced.There is lack of evidence currently on the merits of tibiapro-fibula augmented locking plate fixation of unstable ankle fractures.AIM To assess if there is increased strength to failure,in an ankle fracture saw bone model,with a fibula pro-tibia construct when compared with standard locking plate fixation.METHODS Ten osteoporotic saw bones with simulated supination external rotation injuries were used.Five saw bones were fixed with standard locking plates whilst the other 5 saw bones were fixed with locking plates in a fibula pro-tibia construct.The fibula pro-tibia construct involved fixation with 3 consecutive locking screws applied across 3 cortices proximally from the level of the syndesmosis.All fixations were tested in axial external rotation to failure on an electromagnetic test frame(MTS 858 Mini-Bionix test machine,MTS Corp,Eden Praire,MN,United States).Torque at 30 degrees external rotation,failure torque,and external rotation angle at failure were compared between both groups and statistically analyzed.RESULTS The fibula pro-tibia construct demonstrated a statistically higher torque at 30 degrees external rotation(4.421±0.796 N/m vs 1.451±0.467 N/m;t-test P=0.000),as well as maximum torque at failure(5.079±0.694N/m vs 2.299±0.931 N/m;t-test P=0.001)compared to the standard locking plate construct.The fibula pro-tibia construct also had a lower external rotation angle at failure(54.7±14.5 vs 67.7±22.9).CONCLUSION The fibula pro-tibia locking plate construct demonstrates biomechanical superiority to standard locking plates in fixation of unstable ankle fractures in this saw bone model.There is merit in the use of this construct in patients with unstable osteoporotic ankle fractures as it may aid improved clinical outcomes.

多学科SUPPORT管理模式干预对脊髓损伤并截瘫患者手术效果的影响

【目的】建立基于多学科团队合作的SUPPORT管理模式,有针对性地对脊髓损伤并截瘫患者进行综合评估和干预,评价该管理模式效果,探索提高护理质量和安全的新方法。【方法】从医疗、护理、康复、营养、心理、中医、高压氧等七个医学学科出发,构建SUPPORT护理模式;通过整合资源,联合多个专科,对2017年1月至2018年12月本院收治的58例脊髓.损伤并截瘫手术患者进行综合干预(观察组)。收集2015年1月至2016年12月本院收治的60例脊髓损伤并截瘫手术常规护理患者作为对照(对照组)。比较两组患者在术前等待时间、术后住院时间、总住院时间、住院费用及术后1个月、3个月、1年死亡率。分析两组患者生活质量评分及患者满意度。【结果】观察组在术前等待时间、术后住院时间、总住院时间、住院费用均明显短于对照组,在术后3个月并发症发生率方面明显少于对照组,差异均有统计学意义(P<0.05)。在满意度总分、医护责任心、服务态度和关系病人程度、出院指导四个方面有明显提高,差异均具有统计学意义(P<0.05),在入院介绍、患者对医院整体态度等两个维度无统计学意义(P>0.05).【结论】SUPPORT管理模式的构建,可以规范脊聽损伤并截瘫患者的医疗治疗和管理,科学地进行护理和健康指导,从而缩短住院时间,提高患者满意度。

Suture-anchor锚钉在Weber C型踝关节骨折合并下胫腓联合损伤中的应用

目的 研究Suture-anchor锚钉修复下胫腓前韧带在Weber C型踝关节骨折合并下胫腓联合损伤中的临床应用效果。方法 回顾性分析延安大学附属医院2017年3月至2021年3月间收治的84例Weber C型踝关节骨折合并下胫腓联合损伤患者的临床资料,根据患者下胫腓前韧带修复方法将其分为锚钉组(Suture-anchor锚钉修复,n=39)与螺钉组(皮质骨螺钉内固定,n=45),比较两组患者围术期相关指标、复位质量以及术后6个月美国足踝外科协会(AOFAS)踝足评分系统和踝关节Baird-Jackson功能得分情况。结果 锚钉组患者的手术耗时和术中透视次数分别为(103.69±17.79) min、(14.49±3.36)次,明显短(少)于螺钉组的(126.41±20.15) min和(18.41±4.15)次,差异均具有统计学意义(P<0.05);锚钉组患者的下胫腓联合前间距(ITFACS)为(1.86±0.26) mm,明显短于螺钉组的(2.79±0.32) mm,差异有统计学意义(P<0.05),但两组患者的下胫腓联合后间距(ITFPCS)比较差异无统计学意义(P>0.05);锚钉组患者的骨折愈合时间及术后恢复正常工作时间分别为(3.26±0.43)个月和(3.43±0.63)个月,明显短于螺钉组的(3.61±0.39)个月和(3.79±0.71)个月,差异均有统计学意义(P<0.05);术后6个月,两组患者的Baird-Jackson功能评分系统得分及AOFAS踝足功能量表得分比较差异均无统计学意义(P>0.05);锚钉组患者术后并发症发生率为2.56%,略低于螺钉组的17.78%,但差异无统计学意义(P>0.05)。结论 与皮质骨螺钉内固定比较,带线骨锚钉内固定在治疗Weber C型踝关节骨折合并下胫腓联合损伤中更具优势,其可有效增加下胫腓联合前切迹的解剖复位率,且安全性高。