踝扭伤 · 为什么崴过一次就容易再崴

参考文献 · 6

1. Hertel, J. (2002). Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. Journal of Athletic Training, 37(4), 364-375. Lateral ankle sprains are among the most common sports injuries; the ankle functions as a complex of talocrural, subtalar and inferior tibiofibular joints; lateral sprains typically occur with excessive rearfoot supination on an externally rotated lower leg. The most common predisposition to a sprain is a previous sprain. Chronic instability may be mechanical (pathologic laxity, arthrokinematic change, synovial irritation, degeneration), functional (insufficient proprioception and neuromuscular control) or most likely both. The abstract does not name a specific ligament. pubmed.ncbi.nlm.nih.gov/12937557
2. Hubbard, T. J., & Hicks-Little, C. A. (2008). Ankle ligament healing after an acute ankle sprain: an evidence-based approach. Journal of Athletic Training, 43(5), 523-529. Systematic review of 7 RCTs measuring laxity: ankle laxity improved over 6 weeks to 1 year; ligament healing took at least 6 weeks to 3 months; positive anterior drawer persisted in 3-31% at 6 months; felt instability in 7-42% up to 1 year. 10.4085/1062-6050-43.5.523
3. Bronstein, A. M. (2016). Multisensory integration in balance control. Handbook of Clinical Neurology, 137, 57-66. Review of how visual, proprioceptive, and vestibular inputs interact and are reweighted in upright postural control. 10.1016/B978-0-444-63437-5.00004-2
4. Doherty, C., Bleakley, C., Delahunt, E., & Holden, S. (2017). Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. British Journal of Sports Medicine, 51(2), 113-125. 46 reviews (mean AMSTAR 6.5/11). Acute sprain, pain/swelling/function: strong evidence for NSAIDs and early mobilisation, moderate for exercise and manual therapy, conflicting for surgery and acupuncture, insufficient for ultrasound. Preventing recurrence: strong evidence for bracing, moderate for neuromuscular training. 10.1136/bjsports-2016-096178
5. Bachmann, L. M., Kolb, E., Koller, M. T., Steurer, J., & ter Riet, G. (2003). Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ, 326(7386), 417. 27 studies, 15,581 patients. Pooled negative likelihood ratio 0.08 for ankle and mid-foot (0.07 in children); at 15% fracture prevalence, a negative rule leaves under 1.4% probability of fracture. Sensitivity almost 100%, modest specificity; use should cut unnecessary radiographs by 30-40%. 10.1136/bmj.326.7386.417
6. Stiell, I. G., Greenberg, G. H., McKnight, R. D., Nair, R. C., McDowell, I., & Worthington, J. R. (1992). A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Annals of Emergency Medicine, 21(4), 384-390. The derivation study of the Ottawa ankle rules (prospective, 2 university emergency departments, 750 adults with acute blunt ankle injury). All 70 significant malleolar fractures were in people with pain near the malleoli who were aged 55 or older, had bone tenderness at the posterior edge or tip of either malleolus, or could not bear weight both immediately after the injury and in the emergency department (100% sensitive, 40.1% specific, 36.0% fewer ankle radiographs); all 32 midfoot fractures were in people with midfoot pain and bone tenderness at the base of the fifth metatarsal, the cuboid or the navicular (abstract, PMID 1554175). The refined rules were validated in Stiell 1993, JAMA: sensitivity 1.0 for malleolar and midfoot fractures, with an estimated 34% fewer ankle and 30% fewer foot radiographs (abstract, PMID 8433468). 10.1016/s0196-0644(05)82656-3