[Injuries to the lateral ankle ligaments].

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-12-10 DOI:10.1007/s00113-024-01503-4
Konrad Kamin, Marcel Mäder, Christine Marx, Stefan Rammelt
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Abstract

Acute sprains and ruptures of the lateral ankle ligaments are the most common injuries of the ankle joint. They are often related to sporting activity and predominantly affect individuals under 40 years old. Lateral ligament injuries occur due to supination trauma. The anterior talofibular ligament is most commonly affected often in combination with the calcaneofibular ligament. In contrast, ruptures of all three lateral ankle ligaments (luxatio pedis supinatoria) or complete ruptures of the medial and lateral ligaments (luxatio pedis cum talo) are extremely rare. The clinical diagnostics have a high sensitivity and specificity and X-ray images are used to exclude fractures and other accompanying injuries. In cases of acute injuries conservative treatment in an orthosis for 5-6 weeks to prevent supination is the method of choice. Surgical treatment is reserved for exceptional indications. For both operative and conservative forms of treatment the functional treatment with initial movement exercises in a semi-rigid orthosis and the following proprioceptive training are crucial for the success of treatment and show superior results compared to immobilization in a surgical cast.

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[踝关节外侧韧带受伤]。
踝关节外侧韧带的急性扭伤和断裂是最常见的踝关节损伤。它们通常与体育活动有关,主要影响40岁以下的人。侧韧带损伤是由于旋后创伤引起的。距腓骨前韧带最常与跟腓骨韧带合并受累。相反,所有三个外侧踝关节韧带的断裂(旋足脱位)或内侧和外侧韧带的完全断裂(足距脱位)是非常罕见的。临床诊断具有很高的敏感性和特异性,x线图像用于排除骨折和其他伴随损伤。在急性损伤的情况下,保守治疗矫形器5-6周,以防止旋后是选择的方法。手术治疗是为特殊适应症保留的。无论是手术治疗还是保守治疗,在半刚性矫形器中进行初始运动训练和随后的本体感觉训练的功能治疗对于治疗的成功至关重要,并且与外科石膏固定相比,效果更好。
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