sacroiliac joint sprain
Introduction
Introduction to ankle sprain Ankle sprains, also known as ankle dislocations, are often caused by misaligned postures, sudden changes in muscle strength, and a small number of people without significant history of trauma. The ankle joint consists of an ear-shaped joint surface with uneven convexities and concaves. The ligaments with different lengths are stabilized, and the gravity of the trunk is transmitted to the lower waist through the ankle joint. When pregnant women are affected by endocrine changes, or because of prolonged bed rest, spinal anesthesia or general anesthesia can cause ankle joint relaxation, affecting the stability of the ankle joint, causing ankle sprain or dislocation when subjected to external force, but due to sputum The joints are strong and stable, and are not prone to sprains or misalignment. When the posture is not correct, the muscle strength is disordered, and the ligament is loose, the external force of the torsion may make the uneven surface of the ankle joint disorder, the gap widened, and the synovial membrane is inhaled into the joint space under the negative pressure of the joint cavity, causing severe Pain, depending on the direction of the sprain, can cause anterior dislocation or posterior dislocation of the ankle. basic knowledge The proportion of sickness: 0.01%-0.05% Susceptible people: no specific people Mode of infection: non-infectious Complications: urethral syndrome lumbar degenerative small joint injury arthritis
Cause
Ankle sprain
Physiological factors (30%):
The ankle joint consists of an ear-shaped joint surface that is unevenly interlaced with each other. The ligaments with different lengths are stabilized. The gravity of the trunk is transmitted to the lower back through the ankle joint. When the pregnant woman is affected by endocrine changes, or because of prolonged bed rest, After spinal anesthesia or general anesthesia, it can cause sagging of the ankle joint, affecting the stability of the ankle joint, causing an ankle sprain or dislocation when subjected to external force.
External force factor (30%):
Because the ankle joint is strong and stable, it is not easy to cause sprain or dislocation. When the posture is not correct, the muscle strength is out of balance, and the ligament is loose, the external force of the torsion can make the uneven surface of the ankle joint disorder, the gap widened, and the negative pressure in the joint cavity. In the case of inhalation of the synovial membrane into the joint space, causing severe pain, depending on the direction of the sprain may cause dislocation of the ankle joint or posterior dislocation.
Anterior dislocation of the ankle joint is when the hip joint is straight, the knee joint is flexed, and the quadriceps and patellofemoral ligaments are pulled forward to pull the tibia. The trunk, the spine and the tibia are rotated outwards to make the humerus Front shift.
Dislocation of the ankle joint When the hip joint is flexed, the knee joint is straight, and the hamstring muscle is pulled backwards, when the trunk and the tibia are rotated to the opposite side, the tibia and the tibia are reversed in opposite directions. Causes a posterior rotation of the humerus.
Prevention
Ankle sprain prevention
This disease is usually caused by trauma, so it should be developed into a good habit, correct sitting posture, standing posture, etc. to prevent the occurrence of this disease. Ankle sprain is easy to be associated with radiation pain. About 20% to 60% of patients have ipsilateral lower extremity radiation pain, mostly in the buttocks, posterior thigh (posterior cutaneous nerve) sciatic nerve distribution area and anterior medial thigh root. And get treatment, the disease generally has a good prognosis.
Complication
Ankle sprain complication Complications urethral syndrome lumbar degenerative small joint injury arthritis
Lumbar degeneration
Patients with ankle joint strain due to imbalance of spinal dynamic balance, often associated with severe lumbar degeneration such as lumbar disc herniation, lumbar spondylolisthesis, etc., should be treated in the treatment of ankle joint disease while actively treating lumbar disease.
2. Urethral syndrome
Middle-aged and elderly women with ankle joint strain often affect the pelvic parasympathetic nerve with urethral syndrome, and can use the vibration method to operate the lower abdomen and rub the gossip to relieve the parasympathetic interference state while treating the ankle joint problem. , restore normal urination function.
3. Ankle osteoarthritis
Patients with ankle joint strain may cause synovitis or osteoarthritis due to long-term joint mechanics imbalance and localized articular cartilage over-concentration load. Even if the ankle joint surface returns to normal spatial relationship, it will still cause pain when the lower limbs are loaded. It can be combined with local Chinese medicine hot compress and physiotherapy at the same time as manual treatment; for patients with synovial inflammation, ankle joint closure can be used.
Ankle sprain is easy to be associated with radiation pain. About 20% to 60% of patients have ipsilateral lower extremity radiation pain, mostly in the buttocks, posterior thigh (posterior cutaneous nerve) sciatic nerve distribution area and anterior medial thigh root. And get treatment, the disease generally has a good prognosis, and few other complications occur.
Symptom
Ankle sprain symptoms Common symptoms Lower extremity radiation pain pale pale ankle pain severe pain shock joint sprain neuralgia hip radiation pain
After an ankle sprain, the genital side of the ankle is severely painful, and the movement is not working. The complexion is pale and even shocked. The ipsilateral lower limbs do not dare to bear weight. The trunk is inclined forward and the disease side. About 20% to 60% of patients have ipsilateral Radiation pain in the lower extremities, mostly in the buttocks, the posterior thigh (the posterior cutaneous nerve) of the sciatic nerve and the anterior medial thigh. The pelvic separation test was positive, the adductor muscle was tense, the sacral rotation test was positive, the straight leg elevation was limited, and the posterior superior iliac spine was raised or lowered from the contralateral side, and the tenderness was in the posterior superior iliac spine.
Examine
Ankle sprain
The disease can be diagnosed according to its clinical manifestations and physical examination. X-ray examination is often used for auxiliary examinations:
1, physical examination:
During the examination, it can be found that the posture is stereoscopic, the torso is tilted to the healthy side when standing, the weight of the healthy limb is carried, the waist is pointed to the ground, the hip is supported by the hand to reduce the activity and pain; the sitting posture is the weight of the ischial tuberosity when sitting. Hands are used to reduce the weight; in the bed posture, the patient sits at the bed first, then uses both hands to hold the affected limb to prevent the affected ankle joint from hurting.
The pelvic separation test was positive, the adductor muscle was tense, the sacral rotation test was positive, the straight leg elevation was limited, and the posterior superior iliac spine was raised or lowered from the contralateral side, and the tenderness was in the posterior superior iliac spine.
2, X-ray inspection:
The X-ray anterior film showed two squats and the height of the upper sinus was different. The oblique position showed that the ankle joint gap was widened, and the convex-concave relationship was disordered.
Diagnosis
Diagnosis and diagnosis of ankle sprain
diagnosis:
According to the history of trauma, clinical symptoms and signs, and with reference to X-ray films, the diagnosis can be confirmed. If the pain disappears immediately after hearing the ankle joint sound by the traction method, the diagnosis can be confirmed, but it needs to be associated with lumbosacral sprain and annulus fibrosus. Identification.
Differential diagnosis:
The disease is often due to posture posture disorder, muscle imbalance, sudden torsion and disease, the main surface is the same as the sudden injury of the lateral sacral pain, the movement is not working, some patients may have radiation pain.
Some clinical symptoms have similar symptoms, and need to be differentially diagnosed. The diseases that need to be identified include: lumbosacral sprain and annulus fibrosus.
