From “Low” to “High” Athletic Ankle Sprains: A Comprehensive Review

D’Hooghe, Pieter; Alkhelaifi, Khalid; Abdelatif, Nasef Mohamed Nasef; Kaux, Jean-François

doi:10.1053/j.oto.2018.01.002

Cited by 12 publications

(8 citation statements)

References 60 publications

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“…In the course of this study, we conducted a thorough literature review to identify studies reporting on intra-articular pathologies in patients treated for an acute isolated, unstable syndesmotic injury. Although various authors have recommended arthroscopy [ 11 , 14 , 38 ], only one study mentioned chondral lesions detected by arthroscopy. Unfortunately, these were only reported as a side note, and neither their severity nor their treatment was documented [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Acute, isolated and unstable syndesmotic injuries are frequently associated with intra-articular pathologies

Rellensmann

Behzadi²,

Usseglio

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Although simultaneous arthroscopy for the surgical treatment of acute isolated, unstable syndesmotic injuries has been recommended, little knowledge is present about the actual frequency of intra-articular pathologies for this injury. The aim of this study was to investigate the frequency and severity of intra-articular pathologies detected during arthroscopy and their subsequent treatment in acute isolated, unstable syndesmotic injuries. Methods A retrospective chart review of patients treated by arthroscopic-assisted stabilization for acute isolated, syndesmotic instability was performed. The primary outcome parameter was the frequency of intra-articular pathologies. Secondary outcome parameters were the type of syndesmotic lesion (ligamentous/bony), severity of chondral lesions, MRI findings, treatment details, complications and the identification of factors associated with intra-articular pathologies. Results Twenty-seven patients, 19% female, with a mean age of 37 ± 12 years met the inclusion criteria. 70% suffered isolated ligamentous injuries, the remaining suffered avulsion fractures of the syndesmosis. Chondral lesions occurred in 48% (ICRS grade II: 33%; ICRS grade IV 15%) and intra-articular loose bodies in 11% of patients. Overall, arthroscopy revealed intra-articular pathologies necessitating further treatment in 19% of patients. Neither the type of syndesmotic injury (bony vs. ligamentous; ns) nor the degree of ligamentous instability (West Point IIB vs. III; ns) had a significant influence on the occurrence of chondral lesions. One complication (SSI) occurred. Pre-operative MRI revealed a sensitivity/specificity of 100/79% for chondral lesions and 50/93% for loose bodies. Conclusion Intra-articular pathologies in acute isolated, unstable syndesmotic injuries occur in up to 50% of patients, 19% necessitated additional treatment. Simultaneous arthroscopy, independent of the pre-operative MRI findings, appears reasonable in highly active patients. Level of evidence Level III.

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Section: Introductionmentioning

confidence: 99%

Acute, isolated and unstable syndesmotic injuries are frequently associated with intra-articular pathologies

Rellensmann

Behzadi²,

Usseglio

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…Ovaj relativno snažni ligament okruglastog oblika, duljine od 22 do 43 mm, proteže se od dorzalne strane stražnjeg tuberkula tibije do proksimalnog ruba na maleolarnoj fosi fibule (slika 4). Vlakna TL-a u kontaktu su i djelomično se spajaju s vlaknima PITFL-a 1,23 . Zbog njegova bliskog kontakta s PITFL-om postoje razmimoilaženja u stavovima radi li se o dva zasebna ligamenta ili je to jedna anatomska cjelina.…”

Section: Transverzalni Ligament (Tl)unclassified

“…Ozljeda sindezmoze opisana je u 1 -18 % slučajeva pri uganuću gležnja 1,2 . Zbog boljeg razumijevanja mehanizma nastanka ozljede sindezmoze i zbog boljih dijagnostičkih metoda, novija istraživanja pokazala su da se ozljede sindezmoze javljaju od 17 % pa i do 95 % u sklopu uganuća gležnja 4,6 .…”

Section: Epidemiologijaunclassified

Sindezmoza gležnja

Gulan

Štiglić

Majić

et al. 2020

Med. Flum. (Online)

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Distalni tibiofibularni zglob odgovoran je za širinu i stabilnost takozvane zglobne viljuške gležnja koju sačinjavaju distalna tibija i distalna fibula. Prema nekim autorima tijekom uganuća gležnja u 95 % slučajeva dolazi i do ozljede ligamenta distalnog tibiofibularnog zgloba. Upravo je prepoznavanje ovih ozljeda od velike važnosti, jer se pacijenti s tim ozljedama liječe dvostruko dulje od pacijenata s ozljedama ligamentarnih struktura lateralne strane gležnja, a do povratka sportskim aktivnostima protekne i do 6 mjeseci. Standardni klinički testovi i klasične rendgenske snimke nisu često dostatni za postavljanje dijagnoze, pa je pri sumnji na ozljede sindezmoze potrebno učiniti i magnetsku rezonanciju. Način liječenja akutnih izoliranih ozljeda sindezmoze ovisi o stupnju nestabilnosti gležnja. Danas još uvijek postoje nedoumice i nesuglasja u postavljanju dijagnoze i liječenja takvih ozljeda. U ovom radu pokušali smo na sistematičan način prikazati anatomske karakteristike distalnog tibiofibularnog zgloba, ali i najnovije stavove u dijagnostici i liječenju ozljede sindezmoze.

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“…La mayor parte de los ET afectan el complejo ligamentario lateral tras un trauma en inversión de tobillo y flexión plantar, donde en el 70% de los casos ocurre una lesión aislada del ligamento talofibular anterior (8)(9)(10)(11). El complejo ligamentario medial o deltoideo es más fuerte por lo que se afecta con menor frecuencia, éste se asocia a un trauma de mayor fuerza en eversión de tobillo y rotación externa del pie.…”

Section: Generalidadesunclassified

Manejo conservador de esguinces de tobillo

Vargas¹,

Ulate

Arce

2020

Rev.méd.sinerg.

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Resumen Los esguinces de tobillo son lesiones frecuentes que constituyen una causa importante de incapacidad laboral. El esguince del complejo lateral es el más frecuente y se asocia a un mecanismo de inversión y flexión plantar. El abordaje inicial debe incluir determinar el mecanismo de trauma y considerar factores de riesgo que permitan un diagnóstico oportuno. Actualmente el manejo conservador de los esguinces de tobillo es el estándar de tratamiento pues su costo-efectividad es mejor. Método: Para la elaboración de este artículo se realizó una búsqueda de bibliografía con antigüedad no mayor a 5 años, con excepción de las guías clínicas de las cuáles se incluyó la más reciente disponible. Se buscó los términos “esguince de tobillo”, “manejo de esguinces de tobillo” y “prevención de esguinces de tobillo”, tanto en español como en inglés. Conclusiones: La terapia inicial recomendada es la estrategia RICE (reposo, hielo, compresión, elevación). Los AINEs son una opción aceptable en etapas iniciales. El vendaje compresivo permite manejar el edema y además es razonable utilizar medidas de soporte adicionales según la severidad como tobilleras o soportes semi-rígidos. El abordaje debe ser de movilización y rehabilitación temprana, con un seguimiento prospectivo que permita prevenir complicaciones como la inestabilidad crónica articular y el esguince recurrente.

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From “Low” to “High” Athletic Ankle Sprains: A Comprehensive Review

Cited by 12 publications

References 60 publications

Acute, isolated and unstable syndesmotic injuries are frequently associated with intra-articular pathologies

Acute, isolated and unstable syndesmotic injuries are frequently associated with intra-articular pathologies

Sindezmoza gležnja

Manejo conservador de esguinces de tobillo

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