[PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

Likars'ka sprava Pub Date : 2015-07-01
S N Krasnoperov, I V Shishka, M L Golovaha
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Abstract

Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients.

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[诊断急性踝关节外侧韧带损伤的特殊特点]。
急性踝关节外侧韧带损伤的延迟诊断和随后的不适当治疗导致慢性不稳定的发展和关节退行性过程的快速进展。我们工作的目的是通过开发急性踝关节外侧韧带损伤的诊断算法和治疗策略来提高治疗效果。本研究纳入48例有急性踝关节内翻损伤机制病史的患者。诊断方案包括损伤后48小时和7-10天的临床和放射检查。由于损伤后48小时内临床诊断率较高,需进行7-10天的短期保守治疗,并进行随访和控制临床及影像学不稳定性试验。踝关节内翻损伤的临床症状显示,损伤后7 ~ 10天,损伤韧带突出处局部压痛,外侧部关节周围存在严重血肿,前抽屉和距骨倾斜试验阳性,87%的病例显示韧带破裂。我们开发了一种诊断急性踝关节外侧韧带损伤的算法,使我们能够确定手术修复韧带和保守治疗这些患者的不同适应症。
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