Ankle Sprain

Introduction

Introduction to sprained sprain The ligament of the ankle sprain is loose or partially torn; the severe one is completely broken, and the ankle is subluxated, or the fracture is dislocated. After the ankle sprain, the patient has pain and swelling in the front lower or lower, and may have ecchymoses in the acute phase. At this time, the action of making a foot varus will aggravate the pain, and the foot valgus can be painless. When the ankle sprains, the anterior talofibular ligament is first broken. Only after this ligament is broken, the sac is separated from the ligament. If the anterior talofibular ligament is broken, the accompanying lateral iliac ligament rupture must be examined. In 64% of cases, the anterior talofibular ligament is injured alone, and 17% of the lateral iliac ligament is simultaneously injured. basic knowledge The proportion of the disease: the disease is common, the incidence is about 1-2% Susceptible people: no specific population Mode of infection: non-infectious Complications: joint dislocation fracture fracture

Cause

Cause of sprain

Lateral collateral ligament injury (32%):

Because the ligament on the lateral side of the ankle is weaker than the ligament on the medial side, and the internal hemorrhoid is shorter, it is prone to varus (the inner side of the foot) and damage the lateral collateral ligament. When the ankle joint is dorsiflexed, there is no room for movement of the talus, but in the case of plantar flexion (lifting the heel), the talus can move slightly to both sides, so the ankle joint often has a varus sprain in the plantar flexion position.

Trauma (25%):

When we are ankle joints (such as going down stairs, going downhill, landing after landing, etc.), if we lose balance, it will easily cause the inversion of the joints, resulting in the inversion of the ankle joint, that is, the lateral sprain.

Prevention

Sprain injury prevention

1. Appropriate shoes: The shoes are between the human foot board and the ground, buffering the cushioning force between the lower limbs and the ground, providing proper stability and grounding of the lower limbs.

2, good venue: good site maintenance is often more important than choosing a pair of suitable shoes, the culprit of the ankle sprain is often just a stone, a small bump or a pothole.

3, the protection of the ankle: For those who have been injured by the ankle, it is very important to prevent recurrent sprains, which can be used to protect the ankle joint by means of sticking or shin.

4, restore the function of the ankle: more external protection, it is better to have the ability to control the recurrence of ankle sprain, can be mentioned before the lacing movement, proprioceptive training, foot muscle external muscle training Achieved.

Complication

Ankle sprain complication Complications, joint dislocation, fracture, fracture

Half moon body

The semilunar body is a small nodule of the anterior talofibular ligament. The synovial ligament lining the synovial membrane is struck between the lateral malleolus and the talus, causing a 2 or 3 degree injury to the ligament, resulting in persistent synovitis. Sometimes it is fibrotic swelling and permanent induration. At this time, the fixation has no effect, and injection of an insoluble and soluble corticosteroid mixture and a local anesthetic between the talus and the external iliac crest with significant and lasting improvement requires little surgery. The dorsal median nerve is a sensory branch of the superficial peroneal nerve that traverses the anterior talofibular ligament and is often damaged by a sinus sprain. The scorn of the gods often causes the Tinel sign. Blocking local anesthesia is often an effective treatment.

Tibial tenosynovitis

Chronic swelling of the external hemorrhoid caused by tenosynovitis of the tibialis tendon is caused by a painful sprain caused by varus during walking, and compensation for chronic valgus of the joint. In some cases, dislocation of the iliac crest due to severe ankle sprains can also cause swelling and tenderness.

Sudeck post-traumatic reflex atrophy

Painful swelling of the foot combined with spotted osteoporosis can be secondary to vasospasm caused by an ankle sprain. Need to identify edema caused by ligament injury. The atrophy of Sudeck is characterized by a degree of pain that is disproportionate to what is seen in clinical examinations. Multiple tender points move from one part to another, swimming indefinitely, and having changes in skin moisture or color, which are characteristic manifestations.

Sacral sinus syndrome

The sacral sinus syndrome refers to the persistent pain of the sacral sinus after sprained sprain, and the pathogenesis is unclear. There may be partial rupture of the ligament from the calcaneus or the cruciate ligament. Normal sacral sinus is tender, so check the sides of the ankle for comparison. Because the anterior talofibular ligament is tender near the sacral sinus, persistent pain on the anterior ankle joint is often misdiagnosed as a sacral sinus tumor. Treatment consisted of injecting 0. 25 ml of fludrocredone (40 mg/ml) into the sacral sinus and 1 ml of 2% lidocaine containing 1:100,000 epinephrine.

Symptom

Symptoms of sprained sprains Common symptoms Joint sprained ankle and edema of the foot and ankle joint pain Ankle flexion contracture deformity Foot valgus foot varus avulsion fracture

Pain, swelling, subcutaneous ecchymosis, and active ankle pain were aggravated after sprained ankle. Examination can be found that there is a localized tenderness point in the wound, and the ankle joint is flexed and the pain is aggravated when the foot is turned or valgus.

Examine

sprain check

(1) Pay attention to the pain, the position of the tender point, the degree of swelling, and whether the joint is deformed.

(2) Inversion and valgus test: Invert the ankle joint, check the degree of lateral ligament injury (when the foot is varus, whether the lateral motion range of the ankle joint becomes larger or loose), and then the ankle joint is everted to check the medial ligament injury. degree.

(3) Front drawer test: Push the upper end of the ankle joint backwards with one hand while pulling the heel forward with the other hand to check whether the range of motion becomes larger (compared with the uninjured side).

(4) If it is only a slight sprain, it can continue to apply ice and apply pressure compression to raise the affected limb. If it is a severe sprain, it should be sent to the doctor.

Diagnosis

Diagnostic diagnosis of ankle sprain

According to the clinical manifestations, it should be diagnosed as ankle ligament injury. It is sometimes difficult to diagnose the partial ligament injury, loose or complete fracture. In the extreme varus under pressure, the ankle joint is X-ray film, and the lateral joint can be found. The gap was significantly widened, or the lateral detachment of the talus was found on the lateral radiograph, mostly the lateral collateral ligament was completely damaged, and the avulsion fracture was found in the positive and lateral ankle joints.

When a sprain occurs, joint swelling and pain may occur locally, and the fracture should be differentiated from the fracture. The x-ray can be identified.

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