Wearable devices have been used in the treatment and rehabilitation of ankle injuries.This article systematically reviewed the trials that summarize and evaluate the effectiveness of rehabilitation treatment after an ...Wearable devices have been used in the treatment and rehabilitation of ankle injuries.This article systematically reviewed the trials that summarize and evaluate the effectiveness of rehabilitation treatment after an ankle injury.Three databases,PubMed(1974–2021),Embase,and Web of Science(1950–2021),were searched.The intervention was any wearable device,and the outcome measures were Activities Scale for Kids performance(ASKp),Foot and Ankle Outcome Score(FAOS),American Orthopaedic Foot and Ankle Society(AOFAS),Olerud-Molander Ankle Score(OMAS),and Circumference as measured by any validated outcome measure.Two independent authors evaluated the studies with the Cochrane risk-of-bias tool.Four papers were included,involving 476 participants,with a mean age of 29.3±6.7 years.The mean duration of wearable devices was 3.83 weeks,and the mean length of training was 3.75 weeks.Wearable devices achieved better results compared with control on the functional performance(standardized mean difference[SMD]0.66;95%confidence interval[CI]0.29 to 1.04;I^(2)=76%;P<0.001),as well as ankle score(SMD 0.78;95%CI 0.22 to 1.35;I^(2)=82%;P<0.001).The definitive judgment could not be made due to the variability in training,training duration,and outcomes measurement.Wearable devices are a promising approach that has positive effects on ankle injuries in terms of functional performance and reducing the extent of swelling.There is insufficient evidence from randomized controlled trials(RCTs)to support this for ankle injury patients using wearable devices.Therefore,there is an need for well-conducted randomized controlled trials investigating more adaptive orthoses to achieve more effective strategies for early functional rehabilitation.PROSPERO registration number:CRD42021246289.展开更多
Purpose Lateral ankle sprains(LAS)are associated with corticospinal pathway deficits.Existing evidence is primarily based on cross-sectional investigations and noncausal speculations.This study aims to determine wheth...Purpose Lateral ankle sprains(LAS)are associated with corticospinal pathway deficits.Existing evidence is primarily based on cross-sectional investigations and noncausal speculations.This study aims to determine whether maladaptive corticospinal pathway alterations occur pre-and postligament transection in LAS mouse models.Additionally,this study explores whether the alterations are more pronounced in adolescent mice than adults.Methods Twenty-four 8-week-old adolescent and twenty-four 24-week-old adult mice were randomly assigned to lateral ankle ligament transection or sham surgery.Diffusion-weighted imaging of the corticospinal pathway was performed presurgery and 8 weeks postsurgery.Fractional anisotropy(FA)values,reflecting fiber integrity within the corticospinal subregions of the medulla,pons,midbrain,and cerebrum,were extracted.Results Overall,41 mice completed repeated image acquisition.Before surgery,no significant group effects on FA within the four corticospinal subregions were detected in either adolescent or adult mice.Two months after surgery,the adolescent cohort displayed a significant reduction in FA in the medulla subregion following ankle ligament transection(β-baseline-adjusted=-0.083,95%CI,-0.145 to-0.021,p-corrected=0.048).Conversely,no significant effects of ankle ligament transection on corticospinal FA were observed in the adult cohort.Conclusion The maladaptive alterations in the corticospinal tract could be observed in the adolescent LAS mouse model,characterized by reduced fiber integrity in the medulla subregion.While these results are derived from an animal model,they provide a foundation for future investigations into the mechanisms underlying neurological deficits following musculoskeletal injuries.展开更多
BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion defici...BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion deficits.Strengthening programs targeting evertor/invertor and dorsiflexor/plantar flexor balance help reduce injury recurrence.Bilateral neuromuscular deficits compromise the contralateral side,rendering healthy limbs unsuitable as recovery references.Defining normative healthy ankle parameters is crucial for establishing precise limits in nonsurgical treatments and sports return criteria.While the limb symmetry index(LSI)is used for knees with a cutoff of>90%,no such standardization exists for the ankle.AIM To comprehensively evaluate isokinetic ankle strength profiles in non-athletic individuals.METHODS This is a cross-sectional study.Two hundred ankles were evaluated using the Biodex 3 System to assess eversion,inversion,dorsiflexion,and plantar flexion.Healthy individuals with an active lifestyle and no previous injuries were evaluated.The Maximum Torque,Agonist/Antagonist Ratio,LSI,and Muscular Deficiency Index(MDI)and the correlation with demographic variables were evaluated.RESULTS The mean age(mean±SD)was 38.5±13.5 years,and the body mass index(BMI)was 25.8±4.2 in 69 men and 31 women.The mean maximum torque values by gender were(mean±SD):22.3±6.6 female(F)and 33.4±9.9 male(M)N/m for eversion;30.10±10.0(F)and 37.0±11.6 N/m(M)for inversion,37.4±10.0(F)and 53.6±13.0 N/m(M)for dorsiflexion,and 100.4±37.2(F)and 158.1±33.4(M)N/m for flexion.There was no correlation between age or BMI and maximum torque.The evertors/invertors ratio was 88.8%,and the dorsiflexors/plantar flexors ratio was 36.1%.The MDI and LSI were balanced between sides for every movement,having an average global difference of less than 10%.CONCLUSION These findings provide gender-specific normative isokinetic values for the ankle in healthy,physically active adults.These reference parameters—especially LSI and MDI above 90%—can support clinical decision-making in rehabilitation planning and return-to-sport assessment,offering objective benchmarks for functional recovery.展开更多
Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall ...Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall joint flexibility.At the same time,frozen or hardened ground surfaces heighten impact forces while impairing the body's shock-absorption and adaptive response mechanisms.As a result,injuries such as ankle sprains(ligament tears),tendonitis,and stress fractures become more prevalent.Prevention is therefore essential and should focus on comprehensive warm-up routines,use of thermal and supportive equipment-including ankle braces-selection of footwear with adequate traction,and timely replacement of damp socks after exercise to maintain foot warmth and dryness.展开更多
Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).Th...Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.展开更多
BACKGROUND Ankle fractures are well-documented in snow sports,but concomitant Achilles tendon and peroneal tendon ruptures are rare.This case report presents a previously unreported combination of Achilles tendon rupt...BACKGROUND Ankle fractures are well-documented in snow sports,but concomitant Achilles tendon and peroneal tendon ruptures are rare.This case report presents a previously unreported combination of Achilles tendon rupture,peroneal tendon rupture,and fibular fracture in a snowboarder,highlighting the complex nature of diagnosis,management,and rehabilitation.CASE SUMMARY A 50-year-old male snowboarder presented with severe right ankle pain following a high speed tumbling crash.Initial evaluation revealed an Achilles tendon rupture and a non-displaced distal lateral malleolus fracture.Subsequent magnetic resonance imaging confirmed complete tears of the Achilles tendon and both peroneus longus and brevis tendons,along with a Weber A lateral malleolus fracture.Surgical intervention included a 4-suture core Kraków repair of the Achilles tendon with calcaneal docking,open reduction and internal fixation of the distal fibula fracture,and primary repair of both peroneal tendons.Postoperatively,a modified Achilles repair protocol was implemented.At 16 weeks post-surgery,radiographs showed a well-healed fibular fracture,and physical examination confirmed intact Achilles and peroneal tendon repairs.By 6 months,the patient had regained full daily and work activities,including recreational pursuits.CONCLUSION This case underscores the importance of maintaining a high index of suspicion for concomitant injuries in high-energy ankle trauma during snow sports.Timely advanced imaging and a comprehensive surgical approach are crucial for optimal outcomes in such complex cases.展开更多
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 s...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.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
Objective:To study the clinical effect on old ankle injury treated with collateral bloodletting at ashi point combined with the external application of Sānqī(三七Radix et Rhizoma Notoginseng)powder.Methods:120 outpa...Objective:To study the clinical effect on old ankle injury treated with collateral bloodletting at ashi point combined with the external application of Sānqī(三七Radix et Rhizoma Notoginseng)powder.Methods:120 outpatients with old ankle injury were collected from the Department of Disease Prevention of Shenzhen Pingle Orthopaedics and Traumatology Hospital.Ashi points were selected.The threeedged needle or the syringe needle for single use was used to prick the ashi points for 5-10 times till the slight bleeding presented in local area.Afterwards,the cupping was used at the pricked area for 10-15 min to ensure the complete elimination of stagnant blood.Such therapies were given once a week.On the day after the day of bleeding and cuping,Sanqi powder was applied externally,once a day.The pain score(visual analogue scale,VAS)and the clinical effect were observed in the patients.Results:A total of 115 patients accomplished the whole procedure of treatment The pain mean score of VAS was(3.2±0.4)points before treatment and it were(0.28±0.5)points after treatment.Of them,104 cases were cured completely,8 cases effective significantly and 3 cases failed.Conclusion:The combined treatment with bloodletting therapy at ashi point and the external application of Sanqi powder achieves the satisfactory clinical effect on old ankle injury and this therapy deserves to be promoted in clinical practice.展开更多
Patient-reported outcome measures(PROMs)are essential in orthopedic research and clinical practice,promoting standardized assessments of treatment efficacy and patient well-being.However,their validity across diverse ...Patient-reported outcome measures(PROMs)are essential in orthopedic research and clinical practice,promoting standardized assessments of treatment efficacy and patient well-being.However,their validity across diverse populations depends on rigorous processes of translation,cultural adaptation,and validation.AlMousa et al successfully validated the Arabic version of the American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire,demonstrating strong reliability and clinical applicability for Arabic-speaking patients with traumatic foot and ankle injuries.This article highlights the vital role of culturally adapted PROMs in expanding the global scope of orthopedic research,enhancing patient-centered care,and promoting international collaboration.By addressing linguistic and cultural barriers,such adaptations support a more comprehensive and inclusive approach to evidence-based medicine.Future research should aim to optimize the integration of adapted PROMs into clinical practice,evaluate their influences on treatment decision-making,and investigate their functions in largescale multicenter studies to further globally advance orthopedic research.展开更多
Objective： Conventional fixation of syndesmotic injuries with screws remains problematic. A novel fibrewire device （Tightrope） has suggested advantages. However, small case series have reported high soft tissue com...Objective： Conventional fixation of syndesmotic injuries with screws remains problematic. A novel fibrewire device （Tightrope） has suggested advantages. However, small case series have reported high soft tissue complication rates. The purpose of our study was to quantify complication rates and further procedures in patients treated with Tightropes. A secondary objective was to determine incidence of complications and further procedures in those treated with syndesmotic screws over the same period. Methods： All patients undergoing syndesmotic fixa- tion for ankle fracture between May 2008 and October 2009 were retrospectively reviewed. Incidence of complications, secondary procedures, maintenance of syndesmotic reduc- tion and time spent on non-weight bearing were recorded. Family doctors were contacted for those treated with Tight- ropes to check for any complications managed elsewhere. Results： Thirty-five patients required syndesmoticfixation, in which 12 were treated with Tightropes. They were followed up in clinic for a mean of 12.4 weeks. Family doctors were contacted at mean 14.6 months after treatment to determine any complications suffered. There were no complications attributable to method of fixation. In this series, 12 patients underwent 13 procedures and no patient had recurrent diastasis at discharge; 23 patients treated with screw fixation underwent 45 procedures （19 were screw removals）. There was 1 case ofsyndesmotic diastasis. Screw removal resulted in 2 minor complications. Conclusion： Tightrope fixation provideds effective syndesmotic fixation that is maintained at discharge. We do not experience soft tissue complications reported elsewhere.展开更多
Traumatological and orthopedical diseases with obstruction and blockage are in most cases treated by the reducing method like promoting qi flow and activating blood circulation, dispersing and removing obstruction. Ho...Traumatological and orthopedical diseases with obstruction and blockage are in most cases treated by the reducing method like promoting qi flow and activating blood circulation, dispersing and removing obstruction. However, the therapeutic展开更多
A heightened risk for lateral ankle sprain injuries has been associated with excessive shoe-surface friction.‘Spraino’is a novel product specifically designed towards preventing friction-related lateral ankle sprain...A heightened risk for lateral ankle sprain injuries has been associated with excessive shoe-surface friction.‘Spraino’is a novel product specifically designed towards preventing friction-related lateral ankle sprains.In a recent 510-athlete randomized controlled trial,allocation to this“low-friction”shoe-patch resulted in a 53%reduction of severe ankle sprain injuries.Until now,however,a theoretical explanation linking shoe-surface friction and lateral ankle sprain injury mechanism is missing,and the extent to which Spraino reduces shoesurface friction remains unknown.Therefore,the purpose of this study was to present a theoretical link between lateral edge shoe-surface friction and the mechanism of lateral ankle sprain injuries,and ultimately establish the ability of Spraino to reduce lateral edge shoe-surface friction.In this paper,we present a theory on how ankle sprain mechanics are directly affected by the friction between shoe and surface,and why friction modifications might be a viable preventive strategy.When testing slip resistance in a modified mechanical testsetup,we detected a 63%reduction(0.83–0.31)in friction coefficient between the lateral edge of the outsole and the indoor sports floor when adding Spraino to the side of the shoe.Justified in our theory,and the previously established clinical effectiveness,this reduction in friction can mitigate both the risk and severity of lateral ankle sprain injuries.This suggests that reducing friction on the lateral edge of footwear can be an effective ankle sprain injury prevention strategy.展开更多
Objective:To observe the effect of contralateral needling to regulate tendons and circulate Qi combined with Maitland joint mobilization on ankle joint function and the peri-ankle muscle groups in patients with chroni...Objective:To observe the effect of contralateral needling to regulate tendons and circulate Qi combined with Maitland joint mobilization on ankle joint function and the peri-ankle muscle groups in patients with chronic ankle sprain.Methods:A total of 77 patients with chronic ankle sprain,meeting the inclusion criteria,were randomly divided into a control group(38 cases)and an observation group(39 cases).The control group received conventional acupuncture treatment,while the observation group received contralateral needling to regulate tendons and circulate Qi combined with joint mobilization.Both groups were treated once daily for two consecutive courses.The American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot scale was used to assess ankle joint function in the two groups,and the biomechanical model of skeletal muscles of lower limbs(Gait2392_simbody)was used to evaluate the muscle strength of the peri-ankle muscle groups.Results:The total effective rate in the observation group was 94.9%,significantly higher than the 79.0%in the control group(P<0.05).After treatment,the AOFAS ankle-hindfoot scores in both groups increased compared to their respective pre-treatment scores(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05).After treatment,the maximum muscle strength values of the medial and lateral heads of the gastrocnemius,tibialis posterior,and flexor hallucis longus in both groups increased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The maximum muscle strength values of the soleus and flexor digitorum longus in both groups decreased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were lower than those in the control group(P<0.05).The maximum muscle strength values of the extensor hallucis longus and tibialis anterior in both groups increased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The visual analog scale(VAS)score in both groups decreased compared to their respective pre-treatment score(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).Conclusion:Either the combined therapy(contralateral needling to regulate tendons and circulate Qi combined with joint mobilization)or the conventional acupuncture alone can alleviate pain,improve ankle joint function,and enhance the muscle strength of the peri-ankle muscle groups in patients with chronic ankle sprain,but the combined therapy shows superior efficacy.展开更多
Objective:To explore the mechanism of the action of Huoxue Huayu Lishui prescription on acute ankle joint injury.Methods:Forty-eight SPF rats were randomly divided into blank group,model group,Shujin Huoluo capsule gr...Objective:To explore the mechanism of the action of Huoxue Huayu Lishui prescription on acute ankle joint injury.Methods:Forty-eight SPF rats were randomly divided into blank group,model group,Shujin Huoluo capsule group,low,medium and high dose groups for promoting blood circulation and removing blood stasis.The blank group was not modeled,and the other groups were modeled.Each group of 8 animals,the Shujin Huoluo capsule group was given 0.2g/ml mixed liquid by gavage,and the low,medium and high blood circulation and blood stasis Lishui prescription group was given 1.03g/ml,2.06g/ml,4.12g/ml decoction For the stomach,the normal group was given 1.5ml/100g,once a day for 1 week.The expression of NF-κB P65 and transforming growth factor kinase 1(TAK1)protein in the soft tissue around the ankle joint of rats was detected by sports protein immunoblotting method,and the mRNA expression of NF-κB P65 and TAK1 was detected by PCR technology.Results:One day after modeling,the expressions of P65 and TAK1 mRNA and protein in the model group,the positive drug group,and low,medium and high doses of Huoxue Huayu Lishui Recipe were significantly different from those of the blank control group(P<0.05).After taking the medicine for 7 days,compared with the model group,the expressions of P65 and TAK1 mRNA and protein in the Shujin Huoluo capsule group and the low,medium and high dose Huoxue Huayu Lishui Recipe group were all decreased(P<0.05).After 7 days of taking the medicine,compared with the Shujin Huoxue Capsule group,there was no difference in P65 protein in the low-dose Huoxue Huayu Lishui Recipe group.The expression of P65 protein in the middle and high groups and the Shujin Huoxue Capsule group were all decreased(P<0.05).Compared with the Shujin Huoxue Capsule group,the expressions of TAK1 protein,P65 and TAK1 mRNA in the low,medium,and high groups and the Shujin Huoxue Capsule group were all decreased(P<0.05).The results suggest that Huoxue Huayu Lishui Recipe can inhibit the expression of NF-κB P65 and TAK1 protein in ankle joint injury.Conclusion:Huoxue Huayu Lishui prescription may regulate the expression of NF-κB P65 and TAK1 in ankle joint injury of NF-κB rats,so as to improve the clinical symptoms of local swelling and pain in the ankle joint.展开更多
Background： In treatment of ankle fracture, intraoperative stress tests are used to assess the syndesmotic injury and instability. However, the optimized timing of the strees test should be applied whether in pre- or...Background： In treatment of ankle fracture, intraoperative stress tests are used to assess the syndesmotic injury and instability. However, the optimized timing of the strees test should be applied whether in pre- or post-bony fixation during operation is seldom be reported in previous studies. The different strategies on stress test timing would exhibit opposite results within a type ofpronation-external rotation （PER） fractures with supracollicular medial malleolar （SMM） fractures. This study was designed to assess the 3-year ffmctional outcomes of the special PER fractures with or without a syndesmotic transfixation based on the results of two different intraoperative stress test strategies. Methods： This retrospective cohort study included 61 PER injury-Weber C ankle fractures combined with SMM fractures who were treated in Beijing Jishuitan Hospital between 2013 and 2014 and followed up for 3 years. Stress test was performed twice intraoperatively. A positive intraoperative stress test before bony fixation and a negative intraoperative stress test after bony fixation were found in these included patients. Twenty-nine patients （Group 1 ） were treated without a supplemental syndesmotie screw fixation, according to the negative intraoperative stress test alter bony fixation, while 32 patients （Group 2） were treated with an additional syndesmotic screw fixation based on the positive intraoperative stress test before bony fixation. The American Orthopaedic Foot and Ankle Society （AOFAS）Ankle-Hindfoot Scale and Visual Analog Scale （VAS） for pain scores were the main measurements of outcome. The statistical index of demographic data, fracture morphologic data, time interval of follow-up, AOFAS and VAS were recorded and assessed by SPSS 21.0 software through Fisher exact tests and oneway analysis of variance. The associations between the main outcomes and influential factors were evaluated by linear regression models. Results： We observed no difference in the distribution of age, sex, presence of associated posterior malleolus （PM）, fracture dislocation, and fixation of associated PM between two treatment groups. With the numbers available, no statistically significant association could be detected with regard to the AOFAS （Group 1 vs. Group 2, 96.72 ± 6.20 vs. 94.63 ± 8.26, F = 1.24, P = 0.27） and VAS （Group I vs. Group 2, 1.47 ± 2.14 vs. 0.72 ± 1.49, F = 2.44, P - 0.12） in association with two strategies. Conclusions： The present study indicates no difference to the use of the syndesmotic screw in terms of the ffinctional outcome between syndesmosis transfixation and no-fixation patients among PER-Weber C ankle fi＇acture patients with SMM fracture after 3-year ibllow-up. More attention should be paid to pre- and post-bony-fixation intraoperative stress tests and the morphology of medial malleoli fractures in ankle fractures.展开更多
Objective To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain,swelling and joint dysfunction due to acute ankle sprain.Methods A total of 80 patients with acute a...Objective To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain,swelling and joint dysfunction due to acute ankle sprain.Methods A total of 80 patients with acute ankle sprain were recruited and divided into a control group and a treatment group according to the random number table method,with 40 patients in each group.Both groups received the same conventional interventions.The control group was treated with additional tendon-regulating manipulation,and the treatment group was treated with tendon-regulating manipulation plus sticking-needle acupuncture.The pain,swelling and joint dysfunction of the ankle were observed in both groups before and after 3 d,7 d and 14 d of treatment.Results Before treatment,there was no statistically significant difference in the visual analog scale(VAS)score of pain between the two groups(P>0.05).After treatment,the VAS scores of both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the VAS scores in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in the degree of swelling between the two groups(P>0.05).After treatment,the degrees of swelling in both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d and 7 d of treatment,the degrees of swelling in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistical difference in the degree of swelling between the two groups after 14 d of treatment(P>0.05).Before treatment,there was no statistically significant difference in the American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scale score between the two groups(P>0.05).After treatment,the AOFAS ankle-hindfoot scale scores of both groups showed an increasing trend over time,and all the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the AOFAS ankle-hindfoot scale scores in the treatment group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Based on the routine intervention,the addition of sticking-needle acupuncture and tendon-regulating manipulation was better in alleviating pain and swelling and improving joint function in patients with acute ankle sprain than the addition of tendon-regulating manipulation alone.展开更多
Objective To compare the efficacy of Tuina(Chinese therapeutic massage)plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts,and to explore the feasibility of Tuina...Objective To compare the efficacy of Tuina(Chinese therapeutic massage)plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts,and to explore the feasibility of Tuina for injury intervention in competitive athletes.Methods A total of 64 gymnasts with types Ⅰ-Ⅱ lateral collateral ligament injury of ankle were selected and divided into a control group and an observation group according to a full analysis set based on the intention-to-treat principle,with 32 cases in each group.Patients in the control group received ultrasound and microwave treatment,while those in the observation group received additional Tuina manipulations.The efficacy was evaluated by total effective rate,visual analog scale(VAS)score,and American Orthopedic Foot and Ankle Society ankle-hindfoot scale(AOFAS-AHS)score.Results The total effective rate was 96.9% in the observation group and 90.6% in the control group.There was no statistical difference in the total effective rate between the two groups(P>0.05).The markedly effective rate was 75.0% in the observation group and 46.9% in the control group.The markedly effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the VAS scores of both groups showed a downward trend,and there were statistical differences between different treatment time points in the same group(P<0.05).After one and three months of treatment,the VAS scores of the observation group were lower than those of the control group(P<0.05).There were statistical differences in the AOFAS-AHS score before and after treatment within the same group(P<0.05).After one month of treatment,there was no statistical difference in the AOFAS-AHS score between the two groups(P>0.05).After three months of treatment,the AOFAS-AHS score in the observation group was higher than that in the control group,indicating statistical significance(P<0.05).There was an interaction between time and group(P<0.05).Conclusion Tuina plus physical agents can improve the symptoms of lateral collateral ligament injury of ankle in gymnasts.This combined treatment is superior to physical agents alone in relieving pain and improving joint functions.Therefore,Tuina plus physical agents can be used as a treatment for lateral collateral ligament injury of ankle in gymnasts.展开更多
Twenty cases of ankle sprain were treated on the outside with Tuina combined with physical therapy.After 10 treatments,19 cases restored normal ankle function,and I case got no obvious effect.
Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and...Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and functional exercises.Methods: Totally, 36 cases of the patients with acute soft tissue injury, chronic soft tissue injury and post-fracture sequelae of the ankle joint were treated by Chinese massage therapy, external application or external wash of Chinese herbal drugs, and exercises of dorsal flexion and extension of the ankle joint, to observe the restoration of the ankle functions.Results: In 36 cases of the patients, the results showed remarkable effect in 18 cases, effect in 16 cases, failure in 2 cases and the effective rate in 94.4%.Conclusion: The combined use of Chinese massage therapy, external application of Chinese herbal drugs and functional exercises can produce precise effect in the treatment of soft tissue injury of the ankle joint. Key Words Ankle Injuries - Tuina - Massage Author: CHEN Ming-xia (1971-), female, physicianTranslator: HUANG Guo-qi展开更多
文摘Wearable devices have been used in the treatment and rehabilitation of ankle injuries.This article systematically reviewed the trials that summarize and evaluate the effectiveness of rehabilitation treatment after an ankle injury.Three databases,PubMed(1974–2021),Embase,and Web of Science(1950–2021),were searched.The intervention was any wearable device,and the outcome measures were Activities Scale for Kids performance(ASKp),Foot and Ankle Outcome Score(FAOS),American Orthopaedic Foot and Ankle Society(AOFAS),Olerud-Molander Ankle Score(OMAS),and Circumference as measured by any validated outcome measure.Two independent authors evaluated the studies with the Cochrane risk-of-bias tool.Four papers were included,involving 476 participants,with a mean age of 29.3±6.7 years.The mean duration of wearable devices was 3.83 weeks,and the mean length of training was 3.75 weeks.Wearable devices achieved better results compared with control on the functional performance(standardized mean difference[SMD]0.66;95%confidence interval[CI]0.29 to 1.04;I^(2)=76%;P<0.001),as well as ankle score(SMD 0.78;95%CI 0.22 to 1.35;I^(2)=82%;P<0.001).The definitive judgment could not be made due to the variability in training,training duration,and outcomes measurement.Wearable devices are a promising approach that has positive effects on ankle injuries in terms of functional performance and reducing the extent of swelling.There is insufficient evidence from randomized controlled trials(RCTs)to support this for ankle injury patients using wearable devices.Therefore,there is an need for well-conducted randomized controlled trials investigating more adaptive orthoses to achieve more effective strategies for early functional rehabilitation.PROSPERO registration number:CRD42021246289.
基金supported by the National Natural Science Foundation of China[No.81871823,8207090113,82072510]National Key R&D Program of China[No.2018YFC1312900]+2 种基金Shanghai Natural Science Foundation[No.20ZR1406400]Science and Technology Commission of Shanghai Municipality[No.18JC1410403]Shanghai Municipal Science and Technology Major Project[No.2017SHZDZX01,2018SHZDZX01].
文摘Purpose Lateral ankle sprains(LAS)are associated with corticospinal pathway deficits.Existing evidence is primarily based on cross-sectional investigations and noncausal speculations.This study aims to determine whether maladaptive corticospinal pathway alterations occur pre-and postligament transection in LAS mouse models.Additionally,this study explores whether the alterations are more pronounced in adolescent mice than adults.Methods Twenty-four 8-week-old adolescent and twenty-four 24-week-old adult mice were randomly assigned to lateral ankle ligament transection or sham surgery.Diffusion-weighted imaging of the corticospinal pathway was performed presurgery and 8 weeks postsurgery.Fractional anisotropy(FA)values,reflecting fiber integrity within the corticospinal subregions of the medulla,pons,midbrain,and cerebrum,were extracted.Results Overall,41 mice completed repeated image acquisition.Before surgery,no significant group effects on FA within the four corticospinal subregions were detected in either adolescent or adult mice.Two months after surgery,the adolescent cohort displayed a significant reduction in FA in the medulla subregion following ankle ligament transection(β-baseline-adjusted=-0.083,95%CI,-0.145 to-0.021,p-corrected=0.048).Conversely,no significant effects of ankle ligament transection on corticospinal FA were observed in the adult cohort.Conclusion The maladaptive alterations in the corticospinal tract could be observed in the adolescent LAS mouse model,characterized by reduced fiber integrity in the medulla subregion.While these results are derived from an animal model,they provide a foundation for future investigations into the mechanisms underlying neurological deficits following musculoskeletal injuries.
文摘BACKGROUND Ankle normative values are limited compared to isokinetic knee assessments.Chronic ankle instability correlates with agonist-antagonist imbalances,decreased evertor/invertor ratio,and plantar flexion deficits.Strengthening programs targeting evertor/invertor and dorsiflexor/plantar flexor balance help reduce injury recurrence.Bilateral neuromuscular deficits compromise the contralateral side,rendering healthy limbs unsuitable as recovery references.Defining normative healthy ankle parameters is crucial for establishing precise limits in nonsurgical treatments and sports return criteria.While the limb symmetry index(LSI)is used for knees with a cutoff of>90%,no such standardization exists for the ankle.AIM To comprehensively evaluate isokinetic ankle strength profiles in non-athletic individuals.METHODS This is a cross-sectional study.Two hundred ankles were evaluated using the Biodex 3 System to assess eversion,inversion,dorsiflexion,and plantar flexion.Healthy individuals with an active lifestyle and no previous injuries were evaluated.The Maximum Torque,Agonist/Antagonist Ratio,LSI,and Muscular Deficiency Index(MDI)and the correlation with demographic variables were evaluated.RESULTS The mean age(mean±SD)was 38.5±13.5 years,and the body mass index(BMI)was 25.8±4.2 in 69 men and 31 women.The mean maximum torque values by gender were(mean±SD):22.3±6.6 female(F)and 33.4±9.9 male(M)N/m for eversion;30.10±10.0(F)and 37.0±11.6 N/m(M)for inversion,37.4±10.0(F)and 53.6±13.0 N/m(M)for dorsiflexion,and 100.4±37.2(F)and 158.1±33.4(M)N/m for flexion.There was no correlation between age or BMI and maximum torque.The evertors/invertors ratio was 88.8%,and the dorsiflexors/plantar flexors ratio was 36.1%.The MDI and LSI were balanced between sides for every movement,having an average global difference of less than 10%.CONCLUSION These findings provide gender-specific normative isokinetic values for the ankle in healthy,physically active adults.These reference parameters—especially LSI and MDI above 90%—can support clinical decision-making in rehabilitation planning and return-to-sport assessment,offering objective benchmarks for functional recovery.
基金supported by the Fund for 2023 Heilongjiang Provincial Health Commission Science and Technology Plan(No.20230404070193).
文摘Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall joint flexibility.At the same time,frozen or hardened ground surfaces heighten impact forces while impairing the body's shock-absorption and adaptive response mechanisms.As a result,injuries such as ankle sprains(ligament tears),tendonitis,and stress fractures become more prevalent.Prevention is therefore essential and should focus on comprehensive warm-up routines,use of thermal and supportive equipment-including ankle braces-selection of footwear with adequate traction,and timely replacement of damp socks after exercise to maintain foot warmth and dryness.
基金supported by the General Administration of Sport of China(23QN009)the National Natural Science Foundation of China(12102235)。
文摘Background:The anterior talofibular ligament(ATFL)and the calcaneofibular ligament(CFL)are vulnerable to be torn or ruptured during lateral ankle sprain(LAS),especially in people with chronic ankle instability(CAI).This study aims to determine whether landing with a larger toe-out angle would influence ATFL and CFL strains in people with CAI,aiming to contribute to the development of effective landing strategies to reduce LAS risk.Methods:Thirty participants with CAI(22 males and 8 females,age:21.2±1.2 years,height:176.9±9.0 cm,body mass:70.6±12.1 kg,mean±SD)were recruited.Each participant landed on a specialized trap-door device with their unaffected limbs on a support platform and their affected limbs on a movable platform,which could be flipped 24°inward and 15°forward to mimic LAS conditions.Two landing conditions were tested—i.e.,natural landing(NL,with natural toe-out angle at landing)and toe-out landing(TL,with toe-out angle increased to over 150%of that under the NL conditions).Kinematic data were captured using a 12-camera motion analysis system,and ATFL and CFL strains were calculated using a 3D rigid-body foot model.Paired sample t tests and Pearson's correlations were used to analyze data.Results:Compared to NL conditions,ATFL strain decreased(p<0.001,d=2.42)while CFL strain remained unchanged(p=0.229,d=0.09)under TL conditions.The toe-out angle was negatively and strongly correlated with ATFL strain(r=-0.743,p<0.001)but not with CFL strain(r=0.153,p=0.251).Compared to NL conditions,participants exhibit a lower ankle inversion angle(p<0.001,d=0.494),a higher plantarflexion angle(p<0.001,d=1.101),and no significant difference in external rotation angle(p=0.571,d=0.133)under TL conditions.Conclusion:Toe-out landing may reduce ATFL strain while maintaining CFL strain in people with CAI,thereby reducing the risk of LAS.
文摘BACKGROUND Ankle fractures are well-documented in snow sports,but concomitant Achilles tendon and peroneal tendon ruptures are rare.This case report presents a previously unreported combination of Achilles tendon rupture,peroneal tendon rupture,and fibular fracture in a snowboarder,highlighting the complex nature of diagnosis,management,and rehabilitation.CASE SUMMARY A 50-year-old male snowboarder presented with severe right ankle pain following a high speed tumbling crash.Initial evaluation revealed an Achilles tendon rupture and a non-displaced distal lateral malleolus fracture.Subsequent magnetic resonance imaging confirmed complete tears of the Achilles tendon and both peroneus longus and brevis tendons,along with a Weber A lateral malleolus fracture.Surgical intervention included a 4-suture core Kraków repair of the Achilles tendon with calcaneal docking,open reduction and internal fixation of the distal fibula fracture,and primary repair of both peroneal tendons.Postoperatively,a modified Achilles repair protocol was implemented.At 16 weeks post-surgery,radiographs showed a well-healed fibular fracture,and physical examination confirmed intact Achilles and peroneal tendon repairs.By 6 months,the patient had regained full daily and work activities,including recreational pursuits.CONCLUSION This case underscores the importance of maintaining a high index of suspicion for concomitant injuries in high-energy ankle trauma during snow sports.Timely advanced imaging and a comprehensive surgical approach are crucial for optimal outcomes in such complex cases.
文摘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.
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Objective:To study the clinical effect on old ankle injury treated with collateral bloodletting at ashi point combined with the external application of Sānqī(三七Radix et Rhizoma Notoginseng)powder.Methods:120 outpatients with old ankle injury were collected from the Department of Disease Prevention of Shenzhen Pingle Orthopaedics and Traumatology Hospital.Ashi points were selected.The threeedged needle or the syringe needle for single use was used to prick the ashi points for 5-10 times till the slight bleeding presented in local area.Afterwards,the cupping was used at the pricked area for 10-15 min to ensure the complete elimination of stagnant blood.Such therapies were given once a week.On the day after the day of bleeding and cuping,Sanqi powder was applied externally,once a day.The pain score(visual analogue scale,VAS)and the clinical effect were observed in the patients.Results:A total of 115 patients accomplished the whole procedure of treatment The pain mean score of VAS was(3.2±0.4)points before treatment and it were(0.28±0.5)points after treatment.Of them,104 cases were cured completely,8 cases effective significantly and 3 cases failed.Conclusion:The combined treatment with bloodletting therapy at ashi point and the external application of Sanqi powder achieves the satisfactory clinical effect on old ankle injury and this therapy deserves to be promoted in clinical practice.
基金Supported by the Hubei Provincial Natural Science Foundation,No.2025AFB845Graduate Innovation and Entrepreneurship Fund of Wuhan University of Science and Technology,No.JCX2024044.
文摘Patient-reported outcome measures(PROMs)are essential in orthopedic research and clinical practice,promoting standardized assessments of treatment efficacy and patient well-being.However,their validity across diverse populations depends on rigorous processes of translation,cultural adaptation,and validation.AlMousa et al successfully validated the Arabic version of the American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire,demonstrating strong reliability and clinical applicability for Arabic-speaking patients with traumatic foot and ankle injuries.This article highlights the vital role of culturally adapted PROMs in expanding the global scope of orthopedic research,enhancing patient-centered care,and promoting international collaboration.By addressing linguistic and cultural barriers,such adaptations support a more comprehensive and inclusive approach to evidence-based medicine.Future research should aim to optimize the integration of adapted PROMs into clinical practice,evaluate their influences on treatment decision-making,and investigate their functions in largescale multicenter studies to further globally advance orthopedic research.
文摘Objective： Conventional fixation of syndesmotic injuries with screws remains problematic. A novel fibrewire device （Tightrope） has suggested advantages. However, small case series have reported high soft tissue complication rates. The purpose of our study was to quantify complication rates and further procedures in patients treated with Tightropes. A secondary objective was to determine incidence of complications and further procedures in those treated with syndesmotic screws over the same period. Methods： All patients undergoing syndesmotic fixa- tion for ankle fracture between May 2008 and October 2009 were retrospectively reviewed. Incidence of complications, secondary procedures, maintenance of syndesmotic reduc- tion and time spent on non-weight bearing were recorded. Family doctors were contacted for those treated with Tight- ropes to check for any complications managed elsewhere. Results： Thirty-five patients required syndesmoticfixation, in which 12 were treated with Tightropes. They were followed up in clinic for a mean of 12.4 weeks. Family doctors were contacted at mean 14.6 months after treatment to determine any complications suffered. There were no complications attributable to method of fixation. In this series, 12 patients underwent 13 procedures and no patient had recurrent diastasis at discharge; 23 patients treated with screw fixation underwent 45 procedures （19 were screw removals）. There was 1 case ofsyndesmotic diastasis. Screw removal resulted in 2 minor complications. Conclusion： Tightrope fixation provideds effective syndesmotic fixation that is maintained at discharge. We do not experience soft tissue complications reported elsewhere.
文摘Traumatological and orthopedical diseases with obstruction and blockage are in most cases treated by the reducing method like promoting qi flow and activating blood circulation, dispersing and removing obstruction. However, the therapeutic
基金Innovation Fund Denmark[grant number 7038-00087B].
文摘A heightened risk for lateral ankle sprain injuries has been associated with excessive shoe-surface friction.‘Spraino’is a novel product specifically designed towards preventing friction-related lateral ankle sprains.In a recent 510-athlete randomized controlled trial,allocation to this“low-friction”shoe-patch resulted in a 53%reduction of severe ankle sprain injuries.Until now,however,a theoretical explanation linking shoe-surface friction and lateral ankle sprain injury mechanism is missing,and the extent to which Spraino reduces shoesurface friction remains unknown.Therefore,the purpose of this study was to present a theoretical link between lateral edge shoe-surface friction and the mechanism of lateral ankle sprain injuries,and ultimately establish the ability of Spraino to reduce lateral edge shoe-surface friction.In this paper,we present a theory on how ankle sprain mechanics are directly affected by the friction between shoe and surface,and why friction modifications might be a viable preventive strategy.When testing slip resistance in a modified mechanical testsetup,we detected a 63%reduction(0.83–0.31)in friction coefficient between the lateral edge of the outsole and the indoor sports floor when adding Spraino to the side of the shoe.Justified in our theory,and the previously established clinical effectiveness,this reduction in friction can mitigate both the risk and severity of lateral ankle sprain injuries.This suggests that reducing friction on the lateral edge of footwear can be an effective ankle sprain injury prevention strategy.
文摘Objective:To observe the effect of contralateral needling to regulate tendons and circulate Qi combined with Maitland joint mobilization on ankle joint function and the peri-ankle muscle groups in patients with chronic ankle sprain.Methods:A total of 77 patients with chronic ankle sprain,meeting the inclusion criteria,were randomly divided into a control group(38 cases)and an observation group(39 cases).The control group received conventional acupuncture treatment,while the observation group received contralateral needling to regulate tendons and circulate Qi combined with joint mobilization.Both groups were treated once daily for two consecutive courses.The American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot scale was used to assess ankle joint function in the two groups,and the biomechanical model of skeletal muscles of lower limbs(Gait2392_simbody)was used to evaluate the muscle strength of the peri-ankle muscle groups.Results:The total effective rate in the observation group was 94.9%,significantly higher than the 79.0%in the control group(P<0.05).After treatment,the AOFAS ankle-hindfoot scores in both groups increased compared to their respective pre-treatment scores(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05).After treatment,the maximum muscle strength values of the medial and lateral heads of the gastrocnemius,tibialis posterior,and flexor hallucis longus in both groups increased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The maximum muscle strength values of the soleus and flexor digitorum longus in both groups decreased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were lower than those in the control group(P<0.05).The maximum muscle strength values of the extensor hallucis longus and tibialis anterior in both groups increased compared to their respective pre-treatment values(P<0.05),and the values in the observation group were higher than those in the control group(P<0.05).The visual analog scale(VAS)score in both groups decreased compared to their respective pre-treatment score(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).Conclusion:Either the combined therapy(contralateral needling to regulate tendons and circulate Qi combined with joint mobilization)or the conventional acupuncture alone can alleviate pain,improve ankle joint function,and enhance the muscle strength of the peri-ankle muscle groups in patients with chronic ankle sprain,but the combined therapy shows superior efficacy.
基金Hunan Provincial Traditional Chinese Medicine Scientific Research Program Project(No.201920)National Natural Science Foundation of China(No.81874476)Hunan Natural Science Foundation Project(No.2018JJ2303)。
文摘Objective:To explore the mechanism of the action of Huoxue Huayu Lishui prescription on acute ankle joint injury.Methods:Forty-eight SPF rats were randomly divided into blank group,model group,Shujin Huoluo capsule group,low,medium and high dose groups for promoting blood circulation and removing blood stasis.The blank group was not modeled,and the other groups were modeled.Each group of 8 animals,the Shujin Huoluo capsule group was given 0.2g/ml mixed liquid by gavage,and the low,medium and high blood circulation and blood stasis Lishui prescription group was given 1.03g/ml,2.06g/ml,4.12g/ml decoction For the stomach,the normal group was given 1.5ml/100g,once a day for 1 week.The expression of NF-κB P65 and transforming growth factor kinase 1(TAK1)protein in the soft tissue around the ankle joint of rats was detected by sports protein immunoblotting method,and the mRNA expression of NF-κB P65 and TAK1 was detected by PCR technology.Results:One day after modeling,the expressions of P65 and TAK1 mRNA and protein in the model group,the positive drug group,and low,medium and high doses of Huoxue Huayu Lishui Recipe were significantly different from those of the blank control group(P<0.05).After taking the medicine for 7 days,compared with the model group,the expressions of P65 and TAK1 mRNA and protein in the Shujin Huoluo capsule group and the low,medium and high dose Huoxue Huayu Lishui Recipe group were all decreased(P<0.05).After 7 days of taking the medicine,compared with the Shujin Huoxue Capsule group,there was no difference in P65 protein in the low-dose Huoxue Huayu Lishui Recipe group.The expression of P65 protein in the middle and high groups and the Shujin Huoxue Capsule group were all decreased(P<0.05).Compared with the Shujin Huoxue Capsule group,the expressions of TAK1 protein,P65 and TAK1 mRNA in the low,medium,and high groups and the Shujin Huoxue Capsule group were all decreased(P<0.05).The results suggest that Huoxue Huayu Lishui Recipe can inhibit the expression of NF-κB P65 and TAK1 protein in ankle joint injury.Conclusion:Huoxue Huayu Lishui prescription may regulate the expression of NF-κB P65 and TAK1 in ankle joint injury of NF-κB rats,so as to improve the clinical symptoms of local swelling and pain in the ankle joint.
文摘Background： In treatment of ankle fracture, intraoperative stress tests are used to assess the syndesmotic injury and instability. However, the optimized timing of the strees test should be applied whether in pre- or post-bony fixation during operation is seldom be reported in previous studies. The different strategies on stress test timing would exhibit opposite results within a type ofpronation-external rotation （PER） fractures with supracollicular medial malleolar （SMM） fractures. This study was designed to assess the 3-year ffmctional outcomes of the special PER fractures with or without a syndesmotic transfixation based on the results of two different intraoperative stress test strategies. Methods： This retrospective cohort study included 61 PER injury-Weber C ankle fractures combined with SMM fractures who were treated in Beijing Jishuitan Hospital between 2013 and 2014 and followed up for 3 years. Stress test was performed twice intraoperatively. A positive intraoperative stress test before bony fixation and a negative intraoperative stress test after bony fixation were found in these included patients. Twenty-nine patients （Group 1 ） were treated without a supplemental syndesmotie screw fixation, according to the negative intraoperative stress test alter bony fixation, while 32 patients （Group 2） were treated with an additional syndesmotic screw fixation based on the positive intraoperative stress test before bony fixation. The American Orthopaedic Foot and Ankle Society （AOFAS）Ankle-Hindfoot Scale and Visual Analog Scale （VAS） for pain scores were the main measurements of outcome. The statistical index of demographic data, fracture morphologic data, time interval of follow-up, AOFAS and VAS were recorded and assessed by SPSS 21.0 software through Fisher exact tests and oneway analysis of variance. The associations between the main outcomes and influential factors were evaluated by linear regression models. Results： We observed no difference in the distribution of age, sex, presence of associated posterior malleolus （PM）, fracture dislocation, and fixation of associated PM between two treatment groups. With the numbers available, no statistically significant association could be detected with regard to the AOFAS （Group 1 vs. Group 2, 96.72 ± 6.20 vs. 94.63 ± 8.26, F = 1.24, P = 0.27） and VAS （Group I vs. Group 2, 1.47 ± 2.14 vs. 0.72 ± 1.49, F = 2.44, P - 0.12） in association with two strategies. Conclusions： The present study indicates no difference to the use of the syndesmotic screw in terms of the ffinctional outcome between syndesmosis transfixation and no-fixation patients among PER-Weber C ankle fi＇acture patients with SMM fracture after 3-year ibllow-up. More attention should be paid to pre- and post-bony-fixation intraoperative stress tests and the morphology of medial malleoli fractures in ankle fractures.
文摘Objective To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain,swelling and joint dysfunction due to acute ankle sprain.Methods A total of 80 patients with acute ankle sprain were recruited and divided into a control group and a treatment group according to the random number table method,with 40 patients in each group.Both groups received the same conventional interventions.The control group was treated with additional tendon-regulating manipulation,and the treatment group was treated with tendon-regulating manipulation plus sticking-needle acupuncture.The pain,swelling and joint dysfunction of the ankle were observed in both groups before and after 3 d,7 d and 14 d of treatment.Results Before treatment,there was no statistically significant difference in the visual analog scale(VAS)score of pain between the two groups(P>0.05).After treatment,the VAS scores of both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the VAS scores in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in the degree of swelling between the two groups(P>0.05).After treatment,the degrees of swelling in both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d and 7 d of treatment,the degrees of swelling in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistical difference in the degree of swelling between the two groups after 14 d of treatment(P>0.05).Before treatment,there was no statistically significant difference in the American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scale score between the two groups(P>0.05).After treatment,the AOFAS ankle-hindfoot scale scores of both groups showed an increasing trend over time,and all the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the AOFAS ankle-hindfoot scale scores in the treatment group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Based on the routine intervention,the addition of sticking-needle acupuncture and tendon-regulating manipulation was better in alleviating pain and swelling and improving joint function in patients with acute ankle sprain than the addition of tendon-regulating manipulation alone.
文摘Objective To compare the efficacy of Tuina(Chinese therapeutic massage)plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts,and to explore the feasibility of Tuina for injury intervention in competitive athletes.Methods A total of 64 gymnasts with types Ⅰ-Ⅱ lateral collateral ligament injury of ankle were selected and divided into a control group and an observation group according to a full analysis set based on the intention-to-treat principle,with 32 cases in each group.Patients in the control group received ultrasound and microwave treatment,while those in the observation group received additional Tuina manipulations.The efficacy was evaluated by total effective rate,visual analog scale(VAS)score,and American Orthopedic Foot and Ankle Society ankle-hindfoot scale(AOFAS-AHS)score.Results The total effective rate was 96.9% in the observation group and 90.6% in the control group.There was no statistical difference in the total effective rate between the two groups(P>0.05).The markedly effective rate was 75.0% in the observation group and 46.9% in the control group.The markedly effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the VAS scores of both groups showed a downward trend,and there were statistical differences between different treatment time points in the same group(P<0.05).After one and three months of treatment,the VAS scores of the observation group were lower than those of the control group(P<0.05).There were statistical differences in the AOFAS-AHS score before and after treatment within the same group(P<0.05).After one month of treatment,there was no statistical difference in the AOFAS-AHS score between the two groups(P>0.05).After three months of treatment,the AOFAS-AHS score in the observation group was higher than that in the control group,indicating statistical significance(P<0.05).There was an interaction between time and group(P<0.05).Conclusion Tuina plus physical agents can improve the symptoms of lateral collateral ligament injury of ankle in gymnasts.This combined treatment is superior to physical agents alone in relieving pain and improving joint functions.Therefore,Tuina plus physical agents can be used as a treatment for lateral collateral ligament injury of ankle in gymnasts.
文摘Twenty cases of ankle sprain were treated on the outside with Tuina combined with physical therapy.After 10 treatments,19 cases restored normal ankle function,and I case got no obvious effect.
文摘Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and functional exercises.Methods: Totally, 36 cases of the patients with acute soft tissue injury, chronic soft tissue injury and post-fracture sequelae of the ankle joint were treated by Chinese massage therapy, external application or external wash of Chinese herbal drugs, and exercises of dorsal flexion and extension of the ankle joint, to observe the restoration of the ankle functions.Results: In 36 cases of the patients, the results showed remarkable effect in 18 cases, effect in 16 cases, failure in 2 cases and the effective rate in 94.4%.Conclusion: The combined use of Chinese massage therapy, external application of Chinese herbal drugs and functional exercises can produce precise effect in the treatment of soft tissue injury of the ankle joint. Key Words Ankle Injuries - Tuina - Massage Author: CHEN Ming-xia (1971-), female, physicianTranslator: HUANG Guo-qi
