BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the mod...BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the modern cast.The Opencast®is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related complications.Although this novel cast appears to have more benefits than the conventional synthetic cast,its clinical efficacy and advantages have not been established.AIM To investigate the clinical efficacy and advantages of the newly developed Opencast®based on patients’perspectives in those with ankle inversion injury.METHODS A specifically designed questionnaire consisting of 19 items was used to compare patients’opinions and concerns of the Opencast®and the conventional synthetic cast.The items were focused on subjective patient satisfaction,discomfort,and adverse effects while wearing the cast.Patients with an ankle inversion injury diagnosed as a high-grade ankle sprain were enrolled.The subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast®for 2 wk.They were then required to fill the questionnaire again,after switching to the alternative type of cast for 2 more weeks.RESULTS A total of 22 subjects participated in the study.The synthetic cast appeared to be more rigid and stable than the Opencast®,but there was no significant difference in the amount of pain relief.The likelihood of adverse effects when wearing the synthetic cast was significantly higher.Patient satisfaction tended to be rated higher after wearing the Opencast®.Opencast®showed more subjective vulnerability than the synthetic cast,but there was no significant difference in the redo rate.Patients were more anxious about removal of the synthetic cast than of the Opencast®.CONCLUSION The results indicate that the Opencast®could replace the conventional synthetic cast as it offers increased patient satisfaction,which would in turn increase compliance to treatment.展开更多
Objective： To observe the clinical effects of DING＇s Rolling Technique for acute lumbar sprain. Methods： All of 243 cases of acute lumbar sprain were randomly allocated into two groups. One is the treatment group, ...Objective： To observe the clinical effects of DING＇s Rolling Technique for acute lumbar sprain. Methods： All of 243 cases of acute lumbar sprain were randomly allocated into two groups. One is the treatment group, in which 131 cases were treated with DING＇s Rolling Technique. The other is the control group, in which 112 cases were treated with needling at Houxi （SI 3）, and routine tuina. Results： In the treatment group, 98 cases were cured, 33 cases improved, and there were no cases exhibiting zero effects. In the control group, 80 cases were cured, 29 cases improved, and 3 cases experienced no effect. There is no significant difference in the effective rate between the two groups. Conclusion： the tuina method, DING＇s Rolling Technique has good clinical effects on acute lumbar sprain with easy manipulation.展开更多
Objective： To observe the clinical therapeutic effects of acupuncture at the bony clefts in combination with tuina therapy in the treatment of sprains and strains of minor joints at the four extremities. Methods： Ni...Objective： To observe the clinical therapeutic effects of acupuncture at the bony clefts in combination with tuina therapy in the treatment of sprains and strains of minor joints at the four extremities. Methods： Ninety cases of sprains and strains of minor joints at four extremities [including metacarpophalangeal （metatarsophalangeal） joints] were divided randomly into three groups by the consulting order. Acupuncture group, in which 30 cases were treated by acupuncture at the bony clefts; tuina group, in which 30 cases were treated by tuina therapy; and observation group, in which 30 cases were treated by acupuncture at the bony clefts and tuina therapy. The treatment was given 6 times a week as one course of treatments, and the therapeutic effects were observed after 2 courses of treatments. Results： The cure rates of the observation group, the acupuncture group and the tuina group reached 50.0%, 20.0% and 16.7% respectively, and the total effective rates reached 93.4%, 70.0% and 73.3% respectively. There were statistical significance between the observation group and the acupuncture and tuina groups （P〈0.05）; while there was not a statistical difference between the acupuncture group and the tuina group. It was indicated that the therapeutic effect of the observation group was better than that of the acupuncture group and the tuina group. Conclusion： Acupuncture at the bony clefts in combination with tuina therapy is quite effective in the treatment of sprains and strains of metacarpophalangeal （metatarsophalangeal） joints.展开更多
OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this man...OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation. METHODS:Forty patients with lateral ankle sprains were randomly divided into two groups in a 1∶1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment. RESULTS:Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment(P < 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment(P < 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group(P < 0.05). CONCLUSIONS:The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.展开更多
BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instabilit...BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.展开更多
Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. T...Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. The author has treated 43 cases of acute lumbar sprain by needling Weizhong (BL 40), Houxi (SI 3) and Yaotongdian (EX-UE7) plus kinesitherapy and obtained satisfactory therapeutic results. A report follows.展开更多
Objective To observe the clinical effect of acupuncture on the obsolete lateral malleolus joint sprain. Methods Thirty-one cases of patients with obsolete lateral malleolus joint sprain were selected. Jiexi （解溪 ST...Objective To observe the clinical effect of acupuncture on the obsolete lateral malleolus joint sprain. Methods Thirty-one cases of patients with obsolete lateral malleolus joint sprain were selected. Jiexi （解溪 ST 41） were penetrated to Shenmei （申脉 BL 61）, and Yanglingquan （阳陵泉 GB 34） was applied. The needles were retained for 30 min, and the treatment was performed only once, with follow-up visit after 1 month. Results All the patients were cured after treatment, and without relapse on the follow-up visit after 1 month. Conclusion The clinical effect of acupuncture on the obsolete lateral malleolus joint sprain is remarkable.展开更多
In recent years, the authors have treated 30 cases of acute lumbar sprain by acupuncture combined with point medicinal injection at Tianzhu (BL 10), and obtained quite good therapeutic results, as is reported in the f...In recent years, the authors have treated 30 cases of acute lumbar sprain by acupuncture combined with point medicinal injection at Tianzhu (BL 10), and obtained quite good therapeutic results, as is reported in the following.展开更多
Though with Wide Indications, Acupuncture and Moxibustion are not the Remedy for All Ills Treating diseases with acupuncture-moxibustion has a long history in China, and rich experience has been accumulated in its app...Though with Wide Indications, Acupuncture and Moxibustion are not the Remedy for All Ills Treating diseases with acupuncture-moxibustion has a long history in China, and rich experience has been accumulated in its application. According to a statistics in early 1980’s by prof. Jiao Guorui, a senior researcher from China Academy of Traditional Chinese Medicine, acupuncture-moxibustion therapy has at least been used to treat 307 kinds of diseases, among展开更多
BACKGROUND The tear of the gluteus medius and minimus tendons can cause chronic buttock pain,especially in middle-aged individuals;these tears occur mostly in association with degenerative changes in the muscles and t...BACKGROUND The tear of the gluteus medius and minimus tendons can cause chronic buttock pain,especially in middle-aged individuals;these tears occur mostly in association with degenerative changes in the muscles and tendons.Chronic injuries are more common than acute injuries,and concurrent injuries to the gluteus medius and minimus tendons without chronic pain are rare,especially isolated injuries to both sides of the gluteus minimus;such a case has not yet been reported.CASE SUMMARY The authors present a case of bilateral acute traumatic injuries to the gluteus minimus during buttock strengthening exercises in a 75-year-old male patient.The patient completely returned to his pre-injury lifestyle after 8 weeks of injury,with no limitations,but the diagnosis was initially delayed due to misdiagnosis as lumbar radiculopathy,resulting in unnecessary socio-economic burden on the patient.CONCLUSION When treating patients who complain of hip pain,it is important to consider various causes to make a correct diagnosis.展开更多
OBJECTIVE： Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a r...OBJECTIVE： Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a randomized controlled trial to evaluate the effect of acupuncture-movement therapy versus conventional acupuncture in the trea ment of acute lumbar sprain. METHODS： Sixty patients were randomized into four groups： the acupuncture-movement （AM） group, sham acupuncture-movement （SAM） group, conventional acupuncture （CA） group, and physical therapy （PT） group. Patients in the AM group were treated with acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during acupuncture. Patients in the SAM group were treated with sham acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during sham acupuncture. Con- ventional acupuncture was performed in the CA group, and physical therapy was applied in the PT group. Each treatment lasted for 20 min. Patients were assessed before and after treatment using a visual analogue scale （VAS） and the Roland Morris Questionnaire （RMQ）. RESULTS： The VAS and RMQ scores in the AM group were significantly lower after than before treatment （P 〈 0.01）. The AM group reported lower RMQ scores in after-treatment and 24 h after treatment and lower VAS score in 24 h after treatment in comparison with those of the CA, SAM, and PT groups （P 〈 0.05）. CONCULSlON： Acupuncture-movement therapy is effective for treating acute lumbar sprain with a persistent pain-relief and remarkable improvement of lumbar activity. Movement, that is, lumbar exercise during acupuncture, enhances the effect of acupuncture.展开更多
Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus,...Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.展开更多
Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial ri...Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial risk for developing CAI.This study identifies magnetic resonance imaging(MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.Methods:All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1,2017 to December 1,2019 were identified.Data were collected using the Cumberland Ankle Instability Tool at final follow-up.Demographic and other related clinical variables,including age,sex,body mass index,and treatment were also recorded.Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.Results:A total 131 out of 362 patients with a mean follow-up of 3.0± 0.6 years(mean ± SD;2.0—4.1 years) developed CAI after first-episode LAS.According to multivariable regression,development of CAI after first-episode LAS was associated with 5 prognostic factors:age(odds ratio(OR)=0.96,95% confidence interval(95%CI):0.93-1.00,p=0.032);body mass index(OR=1.09,95%CI:1.02-1.17,p=0.009);posterior talofibular ligament injury(OR=2.17,95%CI:1.05-4.48,p=0.035);large bone marrow lesion of the talus(OR=2.69,95%CI:1.30-5.58,p=0.008),and Grade 2 effusion of the tibiotalar joint(OR=2.61,95%CI:1.39-4.89,p=0.003).When patients had at least 1 positive clinical finding in the 10-m walk test,anterior drawer test,or inversion tilt test,they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.Conclusion:MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the10-m walk test,anterior drawer test,and inversion tilt test.Further prospective and large-scale studies are necessary for validation.展开更多
Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclus...Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclusion criteria for CAL We investigated the prevalence of pain inpeople with CAI and the association between presence of pain and other CAI characteristics.Methods'. Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that usedthe Cumberland Ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland Ankle Instability Tool, whichasks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physicalactivities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteris・tics was analyzed by /2 tests and factors associated with each pain category were analyzed by logistic regression.Results'. Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities,47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong associationbetween ankle instability and ankle pain (/2 = 122.2, p < 0.001, OR = 53& 95% confidence interval (CI): 3.84—7.53). Perceived ankle instability,age and unilateral ankle sprains were independently associated with pain (ankle instability: /2 = 43.29, p < 0.001;age: /2 = 30.37,p < 0.001;unilateral ankle sprains: /2 = 6.25, p < 0.05). There was no significant difference in the presence of pain between genders.Conclusion-. The prevalence of pain in people with CAI was high and was related to perceived ankle instability. Number of sprains, age, genderand unilateral or bilateral sprain did not modify this result except for the first pain category (pain during daily activities). There is large gap incurrent knowledge about the impact of pain in people with CAI, and this topic needs further investigation.展开更多
Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop la...Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop landing activity in subjects with chronic ankle instability (CAI)compared to healthy subjects with no history of CAI.Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects,respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace ( NB),ElementTM brace and ASO brace.Simultaneous recording of three-dimensional kinematic (240 Hz)and GRF (1200 Hz) data were performed.Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of ElementTM against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy coutrols.The ASO brace reduced the first peak vertical GRF whereas ElementTM increased 2nd peak vertical GRF.ElementTM brace reduced eversion range of motion (ROM) and peak eversion velocity compared to NB and ASO.In addition,ElementTM reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO.Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for ElementTM.展开更多
Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral...Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral ankle sprain copers,and healthy controls.Methods:Twenty-three participants with CAI,23 lateral ankle sprain copers,and 24 healthy control participants volunteered.Active motor threshold(AMT),normalized motor-evoked potential(MEP),and cortical silent period(CSP)were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.Results:Participants with CAI had significantly longer CSP at 100%of AMT and lower normalized MEP at 120%of AMT compared to lateral ankle sprain copers(CSP100%:p=0.003;MEP120%:p=0.044)and controls(CSP100%:p=0.041;MEP120%:p=0.006).Conclusion:This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI.Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.展开更多
Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains aff...Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains affect the lateral ligaments,particularly the anterior talofibular ligament.Despite its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic cornerstones.Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules.Several interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.An exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific exercises.Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance testing.There are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and avoid.These include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate rehabilitation.The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.展开更多
Purpose： The purpose of this study was to examine the effects of landing kinematics and electromyographic （EMG） activities of medial gastrocnemius on a combined inversion and plantarflexion surface on the ankle （M...Purpose： The purpose of this study was to examine the effects of landing kinematics and electromyographic （EMG） activities of medial gastrocnemius on a combined inversion and plantarflexion surface on the ankle （MG）, peroneus longus （PL）, and tibialis anterior （TA） muscles. Methods： Twelve recreational athletes performed five drop landings from an overhead bar of 30 cm height on to three surfaces： a flat surface, a 25° inversion surface, and a combined surface of 25° inversion and 25° plantarflexion. The kinematic variables and integrated EMG （IEMG） of the three muscles were assessed using a one-way repeated measures ANOVA and a 3 × 3 （surface × muscle） ANOVA, respectively （p 〈 0.05）. Results： The IEMG results showed a significant muscle by surface interaction. The flat surface induced higher TA activity than the two tilted surfaces. The inverted surface produced significantly higher inversion peak angle and velocity than the flat surface, but similar PL activity across the surfaces. The MG IEMG, ankle plantarflexion angle, and inversion range of motion were significantly higher for the combined surface compared to the inverted surface. Conclusion： These findings suggest that compared to the inversion surface, the combined plantarflexion and inversion surface seems to provide a more unstable surface condition for lateral ankle sprains during landing.展开更多
Background:Several case studies observed that the lateral ankle sprain resulted from a sudden increase in ankle inversion accompanied by internal rotation.However,without sufficient ankle kinetics and muscle activity ...Background:Several case studies observed that the lateral ankle sprain resulted from a sudden increase in ankle inversion accompanied by internal rotation.However,without sufficient ankle kinetics and muscle activity information in the literature,the detailed mechanism of ankle sprain is still unrevealed.The purpose of our case report is to present 2 accidental ankle giving way incidents for participants with chronic ankle instability(CAI)and compare to their normal trials with data of kinematics,kinetics,and electromyography(EMG).Case description:Two young female participants accidentally experienced the ankle giving way when landing on a 25°lateral-tilted force plate.3 D kinematics,kinetics,and muscle activity were recorded for the lower extremity.Qualitative comparisons were made between the giving way trials and normal trials for joint angles,angular velocities,moments,centers of pressure and EMG linear envelopes.Results:One participant’s giving way trial displayed increased ankle inversion and internal rotation angles in the pre-landing phase and at initial contact compared to her normal trials.Another participant’s giving way trial exhibited greater hip abduction angles and delayed activation of the peroneus longus muscle in the pre-landing phase versus her normal trials.Conclusion:A vulnerable ankle position(i.e.,more inverted and internally rotated),and a late activation of peroneus activity in the pre-landing phase could result in the ankle giving way or even sprains.A neutral ankle position and early activation of ankle evertors before landing may be helpful in preventing ankle sprains.展开更多
Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a...Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.展开更多
文摘BACKGROUND Orthopedic physicians typically apply a cast to immobilize a body part that has been injured.There have been no significant structural changes or advances in synthetic casts since the development of the modern cast.The Opencast®is a recently developed type of cast that allows ventilation and direct visual inspection of the skin to avoid cast-related complications.Although this novel cast appears to have more benefits than the conventional synthetic cast,its clinical efficacy and advantages have not been established.AIM To investigate the clinical efficacy and advantages of the newly developed Opencast®based on patients’perspectives in those with ankle inversion injury.METHODS A specifically designed questionnaire consisting of 19 items was used to compare patients’opinions and concerns of the Opencast®and the conventional synthetic cast.The items were focused on subjective patient satisfaction,discomfort,and adverse effects while wearing the cast.Patients with an ankle inversion injury diagnosed as a high-grade ankle sprain were enrolled.The subjects were randomized and instructed to fill the questionnaire after wearing a synthetic cast or an Opencast®for 2 wk.They were then required to fill the questionnaire again,after switching to the alternative type of cast for 2 more weeks.RESULTS A total of 22 subjects participated in the study.The synthetic cast appeared to be more rigid and stable than the Opencast®,but there was no significant difference in the amount of pain relief.The likelihood of adverse effects when wearing the synthetic cast was significantly higher.Patient satisfaction tended to be rated higher after wearing the Opencast®.Opencast®showed more subjective vulnerability than the synthetic cast,but there was no significant difference in the redo rate.Patients were more anxious about removal of the synthetic cast than of the Opencast®.CONCLUSION The results indicate that the Opencast®could replace the conventional synthetic cast as it offers increased patient satisfaction,which would in turn increase compliance to treatment.
文摘Objective： To observe the clinical effects of DING＇s Rolling Technique for acute lumbar sprain. Methods： All of 243 cases of acute lumbar sprain were randomly allocated into two groups. One is the treatment group, in which 131 cases were treated with DING＇s Rolling Technique. The other is the control group, in which 112 cases were treated with needling at Houxi （SI 3）, and routine tuina. Results： In the treatment group, 98 cases were cured, 33 cases improved, and there were no cases exhibiting zero effects. In the control group, 80 cases were cured, 29 cases improved, and 3 cases experienced no effect. There is no significant difference in the effective rate between the two groups. Conclusion： the tuina method, DING＇s Rolling Technique has good clinical effects on acute lumbar sprain with easy manipulation.
文摘Objective： To observe the clinical therapeutic effects of acupuncture at the bony clefts in combination with tuina therapy in the treatment of sprains and strains of minor joints at the four extremities. Methods： Ninety cases of sprains and strains of minor joints at four extremities [including metacarpophalangeal （metatarsophalangeal） joints] were divided randomly into three groups by the consulting order. Acupuncture group, in which 30 cases were treated by acupuncture at the bony clefts; tuina group, in which 30 cases were treated by tuina therapy; and observation group, in which 30 cases were treated by acupuncture at the bony clefts and tuina therapy. The treatment was given 6 times a week as one course of treatments, and the therapeutic effects were observed after 2 courses of treatments. Results： The cure rates of the observation group, the acupuncture group and the tuina group reached 50.0%, 20.0% and 16.7% respectively, and the total effective rates reached 93.4%, 70.0% and 73.3% respectively. There were statistical significance between the observation group and the acupuncture and tuina groups （P〈0.05）; while there was not a statistical difference between the acupuncture group and the tuina group. It was indicated that the therapeutic effect of the observation group was better than that of the acupuncture group and the tuina group. Conclusion： Acupuncture at the bony clefts in combination with tuina therapy is quite effective in the treatment of sprains and strains of metacarpophalangeal （metatarsophalangeal） joints.
基金the National Traditional Chinese Medicine Inheritance and Innovation Team Project:Traditional Chinese Medicine Innovation Team for Prevention and Treatment of Bone and Joint Degenerative Diseases (No. ZYYCXTD-C-202003)National Natural Science Foundation of China:the study on the Quantification and Mechanism of the rotating-pulling-poking manipulation in the Treatment of Lateral Ankle Sprain (No. 81473694)China Academy of Chinese Medical Sciences Science and Technology Innovation Project:Establishment and Promotion of a Simulation Operation Evaluation System for Rotating-pulling-poking Manipulation (CI2021A02015)。
文摘OBJECTIVE:To compare the changes in gait parameters before and after the treatment of lateral ankle sprain using the rotating-pulling-poking manipulation, and explore the potential bio-mechanical mechanism of this manipulation. METHODS:Forty patients with lateral ankle sprains were randomly divided into two groups in a 1∶1 ratio using a random number table. The experimental group were treated by rotating-pulling-poking manipulation and elastic bandage external fixation, while the control group were treated by ice compress and elastic bandage external fixation. The treatment courses of the two groups were both 2 weeks. We used a three-dimensional motion capture system for kinematic measurements and a Bertec gait analysis force measurement system for mechanical measurements, and compared the changes in gait parameters between the two groups of patients before and after treatment. RESULTS:Intragroup comparison showed that the support time, swing time, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly improved compared to those before treatment(P < 0.05). The swing time of the affected feet in the control group was significantly improved compared to that before treatment(P < 0.05). The inter group comparison showed that the gait speed, stride length, peak of back extension, peak of plantar flexion, peak of toe pedal force, and peak of heel landing force of the affected feet in the experimental group were significantly better than those in the control group(P < 0.05). CONCLUSIONS:The rotating-pulling-poking manipulation can effectively improve the patient's gait and range of motion of the affected ankle joint, and enhance the negative gravity in the vertical direction of the affected foot, and the braking and driving forces in the front and back directions. This may be the potential biomechanical mechanism of the rotating-pulling-poking manipulation for treating lateral ankle sprain.
文摘BACKGROUND The anterior talofibular ligament(ATFL)is the most commonly injured ligament in ankle sprains.While most individuals recover with conservative management,some patients develop persistent pain and instability from chronic ATFL tears.Surgical repair is often required,and minimally invasive techniques are gaining popularity.AIM To evaluate the clinical outcomes of a novel,totally percutaneous(TP)modified Broström repair(MBR)for chronic ATFL insufficiency in a cohort of patients who failed conservative treatment.METHODS This retrospective study analyzed 20 patients(14 males,6 females;mean age,28.7 years)who underwent TP-MBR between 2023 and 2024 at a tertiary trauma center.All patients had persistent pain and instability for at least 3 months despite conservative treatment.Diagnosis was confirmed by magnetic resonance imaging,arthroscopy,and stress testing.TP-MBR was performed using suture anchors and percutaneous ligament advancement.Functional outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Karlsson score at a mean follow-up of 1.5 years.RESULTS All procedures were completed successfully with no intraoperative complications.At a mean follow-up of 1.5 years,patients showed significant improvements in American Orthopaedic Foot and Ankle Society score(from 39.85 to 84.4;P<0.001)and Karlsson scores(from 43.8 to 87.4;P<0.001).All patients returned to pre-injury activity levels with resolution of instability.The technique resulted in minimal tissue trauma,reduced operative time,accelerated recovery,and excellent cosmetic outcomes.No recurrences or major complications occurred.CONCLUSION TP-MBR is a safe and effective alternative to open Broström repair for chronic ATFL tears.It offers the benefits of a minimally invasive approach,including less trauma and faster rehabilitation,making it a valuable option for appropriately selected patients.
文摘Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. The author has treated 43 cases of acute lumbar sprain by needling Weizhong (BL 40), Houxi (SI 3) and Yaotongdian (EX-UE7) plus kinesitherapy and obtained satisfactory therapeutic results. A report follows.
文摘Objective To observe the clinical effect of acupuncture on the obsolete lateral malleolus joint sprain. Methods Thirty-one cases of patients with obsolete lateral malleolus joint sprain were selected. Jiexi （解溪 ST 41） were penetrated to Shenmei （申脉 BL 61）, and Yanglingquan （阳陵泉 GB 34） was applied. The needles were retained for 30 min, and the treatment was performed only once, with follow-up visit after 1 month. Results All the patients were cured after treatment, and without relapse on the follow-up visit after 1 month. Conclusion The clinical effect of acupuncture on the obsolete lateral malleolus joint sprain is remarkable.
文摘In recent years, the authors have treated 30 cases of acute lumbar sprain by acupuncture combined with point medicinal injection at Tianzhu (BL 10), and obtained quite good therapeutic results, as is reported in the following.
文摘Though with Wide Indications, Acupuncture and Moxibustion are not the Remedy for All Ills Treating diseases with acupuncture-moxibustion has a long history in China, and rich experience has been accumulated in its application. According to a statistics in early 1980’s by prof. Jiao Guorui, a senior researcher from China Academy of Traditional Chinese Medicine, acupuncture-moxibustion therapy has at least been used to treat 307 kinds of diseases, among
文摘BACKGROUND The tear of the gluteus medius and minimus tendons can cause chronic buttock pain,especially in middle-aged individuals;these tears occur mostly in association with degenerative changes in the muscles and tendons.Chronic injuries are more common than acute injuries,and concurrent injuries to the gluteus medius and minimus tendons without chronic pain are rare,especially isolated injuries to both sides of the gluteus minimus;such a case has not yet been reported.CASE SUMMARY The authors present a case of bilateral acute traumatic injuries to the gluteus minimus during buttock strengthening exercises in a 75-year-old male patient.The patient completely returned to his pre-injury lifestyle after 8 weeks of injury,with no limitations,but the diagnosis was initially delayed due to misdiagnosis as lumbar radiculopathy,resulting in unnecessary socio-economic burden on the patient.CONCLUSION When treating patients who complain of hip pain,it is important to consider various causes to make a correct diagnosis.
基金Supported by Study the mechanism based on the p38MAPK signal pathway mediated by Cautery moxibustion therapy of Hui medicine treatment IDD(The National Natural Science Foundation of China,No.81360567)Evaluation of different moxibustion doses for low back pain:a randomized controlled clinical trial of moxibustion therapy on CV4(Ningxia Natural Science Foundation,No.NZ11208)
文摘OBJECTIVE： Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a randomized controlled trial to evaluate the effect of acupuncture-movement therapy versus conventional acupuncture in the trea ment of acute lumbar sprain. METHODS： Sixty patients were randomized into four groups： the acupuncture-movement （AM） group, sham acupuncture-movement （SAM） group, conventional acupuncture （CA） group, and physical therapy （PT） group. Patients in the AM group were treated with acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during acupuncture. Patients in the SAM group were treated with sham acupuncture at Yintang （EX-HN 3） and exercise of the lumbar region during sham acupuncture. Con- ventional acupuncture was performed in the CA group, and physical therapy was applied in the PT group. Each treatment lasted for 20 min. Patients were assessed before and after treatment using a visual analogue scale （VAS） and the Roland Morris Questionnaire （RMQ）. RESULTS： The VAS and RMQ scores in the AM group were significantly lower after than before treatment （P 〈 0.01）. The AM group reported lower RMQ scores in after-treatment and 24 h after treatment and lower VAS score in 24 h after treatment in comparison with those of the CA, SAM, and PT groups （P 〈 0.05）. CONCULSlON： Acupuncture-movement therapy is effective for treating acute lumbar sprain with a persistent pain-relief and remarkable improvement of lumbar activity. Movement, that is, lumbar exercise during acupuncture, enhances the effect of acupuncture.
文摘Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.
基金supported by the Biomedicine Supporting Program of Shanghai "Science and Technology Innovation Plan" (19441902400)the Ningxia Hui Autonomous Region Key R&D program (2020BCH01001)+1 种基金the Shanghai "Science and Technology Innovation Action Plan" Domestic Science and Technology Cooperation Project (20025800200)the Clinical Research Program of Shanghai Municipal Health Commission (201940367)。
文摘Background:Chronic ankle instability(CAI) is a common sequela following an acute lateral ankle sprain(LAS).To treat an acture LAS more effectively and efficiently,it is important to identify patients at substantial risk for developing CAI.This study identifies magnetic resonance imaging(MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.Methods:All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1,2017 to December 1,2019 were identified.Data were collected using the Cumberland Ankle Instability Tool at final follow-up.Demographic and other related clinical variables,including age,sex,body mass index,and treatment were also recorded.Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.Results:A total 131 out of 362 patients with a mean follow-up of 3.0± 0.6 years(mean ± SD;2.0—4.1 years) developed CAI after first-episode LAS.According to multivariable regression,development of CAI after first-episode LAS was associated with 5 prognostic factors:age(odds ratio(OR)=0.96,95% confidence interval(95%CI):0.93-1.00,p=0.032);body mass index(OR=1.09,95%CI:1.02-1.17,p=0.009);posterior talofibular ligament injury(OR=2.17,95%CI:1.05-4.48,p=0.035);large bone marrow lesion of the talus(OR=2.69,95%CI:1.30-5.58,p=0.008),and Grade 2 effusion of the tibiotalar joint(OR=2.61,95%CI:1.39-4.89,p=0.003).When patients had at least 1 positive clinical finding in the 10-m walk test,anterior drawer test,or inversion tilt test,they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.Conclusion:MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the10-m walk test,anterior drawer test,and inversion tilt test.Further prospective and large-scale studies are necessary for validation.
基金supported by a Ph.D.scholarship from Najran University in Najran,Saudi Arabia
文摘Background'. Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residualimpairment is ankle pain;however, it has not been included in models or inclusion criteria for CAL We investigated the prevalence of pain inpeople with CAI and the association between presence of pain and other CAI characteristics.Methods'. Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that usedthe Cumberland Ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland Ankle Instability Tool, whichasks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physicalactivities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteris・tics was analyzed by /2 tests and factors associated with each pain category were analyzed by logistic regression.Results'. Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities,47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong associationbetween ankle instability and ankle pain (/2 = 122.2, p < 0.001, OR = 53& 95% confidence interval (CI): 3.84—7.53). Perceived ankle instability,age and unilateral ankle sprains were independently associated with pain (ankle instability: /2 = 43.29, p < 0.001;age: /2 = 30.37,p < 0.001;unilateral ankle sprains: /2 = 6.25, p < 0.05). There was no significant difference in the presence of pain between genders.Conclusion-. The prevalence of pain in people with CAI was high and was related to perceived ankle instability. Number of sprains, age, genderand unilateral or bilateral sprain did not modify this result except for the first pain category (pain during daily activities). There is large gap incurrent knowledge about the impact of pain in people with CAI, and this topic needs further investigation.
基金supported in part by DeRoyal Industries, Inc.,Powell,TN,USA
文摘Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop landing activity in subjects with chronic ankle instability (CAI)compared to healthy subjects with no history of CAI.Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects,respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace ( NB),ElementTM brace and ASO brace.Simultaneous recording of three-dimensional kinematic (240 Hz)and GRF (1200 Hz) data were performed.Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of ElementTM against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy coutrols.The ASO brace reduced the first peak vertical GRF whereas ElementTM increased 2nd peak vertical GRF.ElementTM brace reduced eversion range of motion (ROM) and peak eversion velocity compared to NB and ASO.In addition,ElementTM reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO.Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for ElementTM.
文摘Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral ankle sprain copers,and healthy controls.Methods:Twenty-three participants with CAI,23 lateral ankle sprain copers,and 24 healthy control participants volunteered.Active motor threshold(AMT),normalized motor-evoked potential(MEP),and cortical silent period(CSP)were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.Results:Participants with CAI had significantly longer CSP at 100%of AMT and lower normalized MEP at 120%of AMT compared to lateral ankle sprain copers(CSP100%:p=0.003;MEP120%:p=0.044)and controls(CSP100%:p=0.041;MEP120%:p=0.006).Conclusion:This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI.Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.
文摘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.
文摘Purpose： The purpose of this study was to examine the effects of landing kinematics and electromyographic （EMG） activities of medial gastrocnemius on a combined inversion and plantarflexion surface on the ankle （MG）, peroneus longus （PL）, and tibialis anterior （TA） muscles. Methods： Twelve recreational athletes performed five drop landings from an overhead bar of 30 cm height on to three surfaces： a flat surface, a 25° inversion surface, and a combined surface of 25° inversion and 25° plantarflexion. The kinematic variables and integrated EMG （IEMG） of the three muscles were assessed using a one-way repeated measures ANOVA and a 3 × 3 （surface × muscle） ANOVA, respectively （p 〈 0.05）. Results： The IEMG results showed a significant muscle by surface interaction. The flat surface induced higher TA activity than the two tilted surfaces. The inverted surface produced significantly higher inversion peak angle and velocity than the flat surface, but similar PL activity across the surfaces. The MG IEMG, ankle plantarflexion angle, and inversion range of motion were significantly higher for the combined surface compared to the inverted surface. Conclusion： These findings suggest that compared to the inversion surface, the combined plantarflexion and inversion surface seems to provide a more unstable surface condition for lateral ankle sprains during landing.
文摘Background:Several case studies observed that the lateral ankle sprain resulted from a sudden increase in ankle inversion accompanied by internal rotation.However,without sufficient ankle kinetics and muscle activity information in the literature,the detailed mechanism of ankle sprain is still unrevealed.The purpose of our case report is to present 2 accidental ankle giving way incidents for participants with chronic ankle instability(CAI)and compare to their normal trials with data of kinematics,kinetics,and electromyography(EMG).Case description:Two young female participants accidentally experienced the ankle giving way when landing on a 25°lateral-tilted force plate.3 D kinematics,kinetics,and muscle activity were recorded for the lower extremity.Qualitative comparisons were made between the giving way trials and normal trials for joint angles,angular velocities,moments,centers of pressure and EMG linear envelopes.Results:One participant’s giving way trial displayed increased ankle inversion and internal rotation angles in the pre-landing phase and at initial contact compared to her normal trials.Another participant’s giving way trial exhibited greater hip abduction angles and delayed activation of the peroneus longus muscle in the pre-landing phase versus her normal trials.Conclusion:A vulnerable ankle position(i.e.,more inverted and internally rotated),and a late activation of peroneus activity in the pre-landing phase could result in the ankle giving way or even sprains.A neutral ankle position and early activation of ankle evertors before landing may be helpful in preventing ankle sprains.
文摘Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.
