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1、踝关节扭伤患者指南 胜利油田中心医院 手外科 足踝外科 姜剑魁 1 2019 11 26 踝关节扭伤患者指南 Ankle Sprain 踝关节扭伤 A Patient s Guide to Ankle Sprain 踝关节扭伤患者指南 Introduction 简介 2 2019 11 26 3 2019 11 26 An ankle sprain is a common injury and usually results when the ankle is twisted or turned in inverted The term sprain signifies injury to t
2、he soft tissues usually the ligaments of the ankle 踝关节扭伤是生活中很常见的损伤 通 常是由于踝关节内翻损伤所导致 术语 扭 伤 一般指的是软组织的损伤 在踝关节 通常指的是韧带损伤 4 2019 11 26 This guide will help you understand how an ankle sprain occurs how doctors diagnose the condition what can be done to treat a sprain 本指南旨在帮助你了解 踝关节扭伤是怎样发生的 如何诊断踝关节扭伤 如何治
3、疗踝关节扭伤 5 2019 11 26 Anatomy 解剖 What part of the ankle is involved 踝关节包括哪些结构 6 2019 11 26 Anatomy 解剖 What part of the ankle is involved 踝关节包括哪些结构 7 2019 11 26 8 2019 11 26 Ligaments are tough bands of tissue that help connect bones together Three ligaments make up the lateral ligament complex on the
4、side of the ankle farthest from the other ankle They are theanterior talofibular ligament ATFL the calcaneofibular ligament CFL and the posterior talofibular ligament PTFL The common inversion injury to the ankle usually involves two ligaments the ATFL and CFL Normally the ATFL keeps the ankle from
5、sliding forward and the CFL keeps the ankle from rolling inward on its side 9 2019 11 26 韧带是一种致密的带状组织 它把相邻骨 关节连接在一起 踝关节外侧韧带复合体 由三条韧带组成 距腓前韧带 跟腓韧带 距腓后韧带 踝关节内翻扭伤通常累及 其中两条韧带 距腓前韧带和跟腓韧带 距腓前韧带防止踝关节前移 跟腓韧带防 止踝关节过度内收 10 2019 11 26 11 2019 11 26 A ligament is made up of multiple strands of connective tissue
6、 similar to a nylon rope A sprain results in stretching or tearing of the ligaments Minor sprains only stretch the ligament A tear may be either a complete tear of all the strands of the ligament or a partial tear of only some of the strands The ligament is weakened by the injury how much it is weak
7、ened depends on the degree of the sprain 12 2019 11 26 韧带是由多股束带状结缔组织组成 很像 是一股尼龙绳 扭伤会导致韧带的拉伤或 撕裂 轻微扭伤仅仅导致韧带的拉伤 严 重扭伤会导致韧带撕裂 而韧带撕裂既可 能是韧带内全部束带的断裂 也可能是部 分束带的断裂 韧带损伤 后 其力量会减 弱 具体减弱的程度取决于扭伤的程度 13 2019 11 26 The lateral ligaments are by far the most commonly injured ligaments in a typical inversion injury
8、 of the ankle In an inversion injury the ankle tilts inward meaning the bottom of the foot angles toward the other foot This forces all the pressure of your body weight onto the outside edge of the ankle As a result the ligaments on the outside of the ankle are stretched and possibly torn 14 2019 11
9、 26 踝关节外侧韧带损伤 最常见于踝关节内 翻损伤 何谓踝关节内翻损伤 就是发生 扭伤时 扭伤的这只脚的足底朝向另外一 只脚 这样全身的重量都集中于踝关节的 外侧 结果导致了踝关节外侧韧带的拉伤 或撕裂 15 2019 11 26 16 2019 11 26 A severe form of ankle sprain called an ankle syndesmosis injury involves damage to other supportive ligaments in the ankle This type of injury is sometimes called a hig
10、h ankle sprain because it involves the ligaments above theankle joint In an ankle syndesmosis injury at least one of the ligaments connecting the tibia and fibula bones the lower leg bones is sprained Recovering from even mild injuries of this type takes at least twice as long as from a typical ankl
11、e sprain 17 2019 11 26 有一种严重的踝关节扭伤 又称踝关节下 胫腓联合损伤 累及踝关节的其他支持韧 带 这种类型的踝关节扭伤又称高位踝关 节扭伤 因为它累及的韧带位于踝关节上 方 踝关节下胫腓联合损伤发生时 至少 有一条连接胫腓骨远端的韧带发生拉伤或 撕裂 即使是轻微的下胫腓联合损伤 其 恢复时间至少是普通踝关节扭伤的两倍 18 2019 11 26 19 2019 11 26 Symptoms 症状 What does an ankle sprain feel like 踝关节扭伤后有哪些表现 20 2019 11 26 21 2019 11 26 Initially
12、the ankle is swollen painful and may turnecchymotic bruised The bruising and swelling are due to ruptured blood vessels from the tearing of the soft tissues Most of the initial swelling is actually bleeding into the surrounding tissues The ankle swells as extra fluid continues to leak into the tissu
13、es over the 24 hours following the sprain 22 2019 11 26 踝关节扭伤发生后 最初的症状是肿胀 疼痛 淤青 这是由于撕裂的软组织内血 管发生破裂 进而血液渗出到踝关节周围 所致 随着扭伤后24小时或更长时间 额 外的液体不断渗漏入组织 踝关节发生肿 胀 23 2019 11 26 People who have sprained an ankle often end up spraining the ankle again If the ankle keeps turning in with activity the condition is
14、 called ankle instability Patients who have ankle instability lose confidence in their ankle to support them especially on uneven ground They often have swelling around the ankle that doesn t go away Pain and swelling in a joint can cause a reflex where the body turns off the muscles around the join
15、t This can cause times when the ankle feels like it is going to give way meaning it may have a tendency to twist again very easily 24 2019 11 26 一旦踝关节发生过一次扭伤 就很容易再 次发生扭伤 如果踝关节反复多次扭伤 这被称之为 踝关节不稳 这种情况会导致 患者对他们的踝关节的功能失去信心 尤 其是在凹凸不平的路面行走时 这类患者 的踝关节总是反复肿胀而不能消退 关节 的疼痛和肿胀会反射性地使人们不使用关 节周围的肌肉 这会不时地让人们感觉踝 关节似
16、乎将要垮掉了 也说是说踝关节更 容易再次扭伤 25 2019 11 26 People who have had several mild ankle sprains or one severe sprain are prone to impingement problems in the ankle The ligaments that were sprained may become irritated and thickened causing them to get pinched near the edge of the ankle joint 反复多次的轻度踝关节扭伤或一次严重 的踝关节扭伤均可导致踝关节撞击综合征 扭伤韧带会发炎并增厚 导致在踝关节 边缘附近出现撞击 26 2019 11 26 Diagnosis 诊断 How do doctors diagnose the condition 医生是如何诊断踝关节扭伤的 27 2019 11 26 The diagnosis of an ankle sprain is usually made by examinatio
