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引用次数: 0
摘要
踝关节扭伤是踝关节最常见的损伤,可能导致慢性踝关节不稳定(CAI)。随着对新型手术技术的探索和对以前未曾认识到的解剖学成分的识别,我们对 CAI 潜在机制的理解有了长足的进步。本综述旨在广泛概述 CAI,包括其病理生理学、流行病学、临床评估、治疗和康复。CAI 的治疗需要多方面的算法,包括历史分析、临床评估和影像诊断。CAI 的手术干预主要涉及解剖和/或非解剖重建和/或修复距骨胫骨前韧带。与非解剖性修复相比,解剖性修复的功能效果更好,继发性骨关节炎的风险也更低。非解剖方法无法复制距骨胫骨前韧带的正常生物力学,可能导致术后僵硬。本综述旨在对这一问题的最新文献进行学术回顾,为临床实践量身定制,目的是帮助外科医生了解这一关键主题。
Recent advances in the management of chronic ankle instability.
Ankle sprains are the most common lesion of the ankle joint which might result in chronic ankle instability (CAI). Significant strides have been taken to enhance our comprehension of the underlying mechanisms of CAI, as the exploration of novel surgical techniques and the identification of previously unrecognized anatomical components. The present review aims to provide an extensive overview of CAI, encompassing its pathophysiology, epidemiology, clinical assessment, treatment, and rehabilitation. Treatment of CAI requires a multifaceted algorithm, involving historical analysis, clinical evaluations, and diagnostic imaging. Surgical interventions for CAI primarily involve the anatomical and/or non-anatomical reconstruction and/or repair of the anterior talofibular ligament. Anatomical repair has exhibited superior functional outcomes and a reduced risk of secondary osteoarthritis compared to non-anatomical repair. Non-anatomical approaches fall short of replicating the normal biomechanics of the anterior talofibular ligament, potentially leading to postoperative stiffness. This review seeks to academically review and up-to-date literature on this issue, tailored for clinical practice, with the intent of aiding surgeons in staying abreast of this critical subject matter.
期刊介绍:
Chinese Journal of Traumatology (CJT, ISSN 1008-1275) was launched in 1998 and is a peer-reviewed English journal authorized by Chinese Association of Trauma, Chinese Medical Association. It is multidisciplinary and designed to provide the most current and relevant information for both the clinical and basic research in the field of traumatic medicine. CJT primarily publishes expert forums, original papers, case reports and so on. Topics cover trauma system and management, surgical procedures, acute care, rehabilitation, post-traumatic complications, translational medicine, traffic medicine and other related areas. The journal especially emphasizes clinical application, technique, surgical video, guideline, recommendations for more effective surgical approaches.