Evaluation of Ankle Lateral Ligament Injuries in Sports Trauma
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Piedalīšanās sporta aktivitātēs ir ļoti izplatīts cilvēku veselīgā dzīvesveida izpausmes veids mūsdienu sabiedrībā. Viens no izplatītākajiem sportistu savainojumiem ir pēdas locītavas laterālās saites trauma, kas parasti tiek saukta par „izmežģīto potīti”. Tā kā šī zona ir tāda anatomiska zona, par kuru medicīnas studenti un profesionāļi ortopēdijas nozarē jūtas vismazāk pārliecināti, šis darbs sniedz pārskatu par cilvēka pēdas locītavas anatomiju un fizioloģiju, īpašu uzmanību veltot pēdas locītavas laterālās saites traumu rašanās iemesliem, kā arī diagnostikai un ārstēšanai.
Šī pētījuma mērķis ir nodrošināt labāku izpratni par cilvēka pēdas locītavu, kā arī piedāvāt uz pierādījumiem balstītu pieeju pēdas locītavas laterālās saites traumu gadījumos.
Izmantojot dažādus literatūras avotus tika atklāts, ka pēdas locītavas laterālās saites savainojumi visbiežāk rodas pārmērīgas pēdas inversijas dēļ, kas rodas ārējā spēka iedarbībās rezultātā. Šī kustība ir iespējama subtalārajā locītavā un izraisa, pirmkārt, dažādu pakāpju priekšējās talofibulārās saites bojājumus, atkarībā no patoloģiskās kustības apjoma. Teorētiski pēdas inversija var būt novērsta ar peroneālo muskuļu antagonizējošu darbību, taču bieži pēkšņu un piespiedu kustību laikā to nevar panākt, aizkavētas muskuļu reakcijas dēļ.
Galvenie diagnostikas rīki pēdas locītavas laterālās saites savainojumu gadījumos ir Otavas pēdas locītavas noteikumi, pacienta klīniskā ortopēdiskā izmeklēšana, ieskaitot speciālos testus. Rentgens var tikt izmantots laterālās potītes lūzuma diagnostikai. Magnētisko rezonansi var izmantot, lai apstiprinātu diagnozi un diagnosticētu saišu savainojumu pakāpi.
Pārsvarā tiek veikta konservatīva ārstēšana. Ķirurģiska ārstēšana ir diskutējama opcija III pakāpes saišu traumu gadījumos profesionāliem sportistiem. Konservatīva ārstēšana nozīmē mieru, aukstuma aplikācijas, kājas pacelšanu 4-5 dienu laikā pēc savainošanas. Lai mazinātu sāpes, var lietot NPL. Pēc tam seko agrīnā mobilizācija ar stabilitātes balstu (funkcionālā ārstēšana). Lielākā daļa sportistu sāk atkal trenēties vienas nedēļas laikā.
Participation in sporting activities is a very popular way for people to pursuit a healthy lifestyle in today's society. One of the most common injuries of athletes is a lateral ankle injury, commonly referred to as a "twisted ankle". The ankle region being the anatomic area which medical students and orthopaedic professionals feel least confident in, this paper reviews the anatomy and physiology of the ankle joint with the focus on finding causes for lateral ankle injuries to occur, as well as how to diagnose and treat them. This paper aims to provide a greater understanding of the human ankle joint, as well as to suggest an evidence based approach to patients' ankle injuries. With the help of various literature sources it was found that lateral ankle injuries most often occur due to excessive inversion movement of the foot by external force. The movement is allowed through the subtalar joint and causes various degrees of damage to primarily the anterior talofibular ligament, depending on the extent of the pathological movement. In theory, the foot inversion could be inhibited by the antagonizing action of peroneal muscles. However, this is often not achieved during sudden forced movements, due to a delayed reaction time of the muscles. The main diagnostic tools of lateral ankle injuries are the use of the Ottawa ankle rules, the drawer- and tilt tests. X-ray imaging should only be used if a fracture is suspected. MRI imaging can be used as a confirmatory test and to visualize the degree of ligament injury. In general, conservative treatment is recommended over surgical treatment. Surgical treatment may be a debatable option for professional athletes with grade III ligament injury. Conservative treatment refers to rest, icing, compression and elevation during the first 4-5 days post injury. NSAIDs can be prescribed for pain relief. Early mobilization with stability support (functional treatment) should follow. Most athletes return to play within one week.
Participation in sporting activities is a very popular way for people to pursuit a healthy lifestyle in today's society. One of the most common injuries of athletes is a lateral ankle injury, commonly referred to as a "twisted ankle". The ankle region being the anatomic area which medical students and orthopaedic professionals feel least confident in, this paper reviews the anatomy and physiology of the ankle joint with the focus on finding causes for lateral ankle injuries to occur, as well as how to diagnose and treat them. This paper aims to provide a greater understanding of the human ankle joint, as well as to suggest an evidence based approach to patients' ankle injuries. With the help of various literature sources it was found that lateral ankle injuries most often occur due to excessive inversion movement of the foot by external force. The movement is allowed through the subtalar joint and causes various degrees of damage to primarily the anterior talofibular ligament, depending on the extent of the pathological movement. In theory, the foot inversion could be inhibited by the antagonizing action of peroneal muscles. However, this is often not achieved during sudden forced movements, due to a delayed reaction time of the muscles. The main diagnostic tools of lateral ankle injuries are the use of the Ottawa ankle rules, the drawer- and tilt tests. X-ray imaging should only be used if a fracture is suspected. MRI imaging can be used as a confirmatory test and to visualize the degree of ligament injury. In general, conservative treatment is recommended over surgical treatment. Surgical treatment may be a debatable option for professional athletes with grade III ligament injury. Conservative treatment refers to rest, icing, compression and elevation during the first 4-5 days post injury. NSAIDs can be prescribed for pain relief. Early mobilization with stability support (functional treatment) should follow. Most athletes return to play within one week.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
potīte, bojājums, laterālās, saites, sporta, trauma, ankle, injury, lateral, ligament, sports, trauma