Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- acute onset of symptoms
- mechanism of injury
- severe pain
- swelling
- bruising
- palpable gap in normal position for Achilles tendon (Achilles tendon rupture)
- positive calf squeeze test (Achilles tendon rupture)
- positive Matles test (Achilles tendon rupture)
- positive biceps squeeze test (biceps tendon rupture)
- positive Hook test (biceps tendon rupture)
- pop sound
- deformity
Outros fatores diagnósticos
- previous injury
- symptom duration more than a few days
- limited range of motion (ROM)
- weakness
Fatores de risco
- type of sports (basketball, ice skating, soccer, contact sports)
- anatomic variation
- eccentric exercise
- pennate muscle architecture and type II muscle fibers (fast twitch)
- muscle-tendon units that span 2 joints
- previous history of ankle sprain
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- x-rays
- MRI
- ultrasound for nonligament injuries
Investigações a serem consideradas
- diagnostic arthroscopy
Algoritmo de tratamento
presenting within the first 24 to 48 hours: incomplete rupture (grade 1 or 2) suspected
presenting within the first 24 to 48 hours: confirmed complete rupture (grade 3)
with worse pain and/or without functional improvement at 1-week review
Colaboradores
Autores
Senthil N. Sambandam, MBBS, MS, MRCS(Edn)
Staff Orthopaedic Surgeon
Department of Orthopaedics
VA Medical Center
Cheyenne
WY
Declarações
SNS declares that he has no competing interests.
Varatharaj Mounasamy, MD, FRCS
Assistant Professor
Department of Orthopaedic Surgery
Virginia Commonwealth University
Richmond
VA
Declarações
VM is an editorial board member, European Journal of Orthopaedic Surgery & Traumatology.
Sakthivel Rajaram Manoharan, MD, MS
Spinal Clinical Research Fellow
Queens Medical Centre
Nottingham
UK
Declarações
SRM declares that he has no competing interests.
Agradecimentos
Dr Senthil N. Sambandam, Dr Varatharaj Mounasamy, and Dr Sakthivel Rajaram Manoharan would like to gratefully acknowledge Dr Issada Thongtrangan, a previous contributor to this topic. IT declares that he has no competing interests.
Revisores
Quanjun Cui, MD
Assistant Professor
Department of Orthopaedics
University of Virginia
Charlottesville
VA
Declarações
QC declares that he has no competing interests.
Nicola Maffulli, MD, MS, PhD, FRCS(Orth)
Professor of Trauma and Orthopaedic Surgery
University Hospital of North Staffordshire
Keele University School of Medicine
Stoke on Trent
UK
Declarações
NM is an author of a study referenced in this topic.
Referências
Principais artigos
Bahr R. Can we prevent ankle sprains? In: MacAuley D, Best TM, eds. Evidence-based sports medicine, 14th ed. London: BMJ, 2002:470.
Fong DT, Hong Y, Chan LK, et al. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007;37:73-94. Resumo
Noonan TJ, Garrett WE Jr. Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg. 1999;7:262-269. Resumo
Speer KP, Lohnes J, Garett WE Jr. Radiographic imaging of muscle strain injury. Am J Sports Med. 1993;21:89-95. Resumo
Boutin RD, Fritz RC, Steinbach LS. Imaging of sports-related muscle injuries. Radiol Clin North Am. 2002;40:333-362. Resumo
Wexler RK. The injured ankle. Am Fam Physician. 1998;57:474-480.Texto completo Resumo
Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018 Aug;52(15):956.Texto completo Resumo
Hertel J. The role of nonsteroidal anti-inflammatory drugs in the treatment of acute soft tissue injuries. J Athl Train. 1997;32:350-358.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Fracture
- Cartilage injury
Mais Diagnósticos diferenciaisDiretrizes
- ACR Appropriateness Criteria Acute Trauma to the Ankle
- Nonpharmacologic and pharmacologic management of acute pain from non–low back, musculoskeletal injuries in adults: a clinical guideline from the American College of Physicians and American Academy of Family Physicians
Mais DiretrizesFolhetos informativos para os pacientes
Ankle sprain
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal