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Musculoskeletal sprains and strains

Последний просмотренный: 11 Jun 2025
Last updated: 28 Jan 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • 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
Полная информация

Другие диагностические факторы

  • previous injury
  • symptom duration more than a few days
  • limited range of motion (ROM)
  • weakness
Полная информация

Факторы риска

  • 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
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • x-rays
  • MRI
  • ultrasound for nonligament injuries
Полная информация

Исследования, проведение которых нужно рассмотреть

  • diagnostic arthroscopy
Полная информация

Алгоритм лечения

Острый

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)

ПРОДОЛЖЕНИЕ

with worse pain and/or without functional improvement at 1-week review

Составители

Авторы

Senthil N. Sambandam, MBBS, MS, MRCS(Edn)

Staff Orthopaedic Surgeon

Department of Orthopaedics

VA Medical Center

Cheyenne

WY

Раскрытие информации

SNS declares that he has no competing interests.

Varatharaj Mounasamy, MD, FRCS

Assistant Professor

Department of Orthopaedic Surgery

Virginia Commonwealth University

Richmond

VA

Раскрытие информации

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

Раскрытие информации

SRM declares that he has no competing interests.

Выражение благодарностей

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.

Рецензенты

Quanjun Cui, MD

Assistant Professor

Department of Orthopaedics

University of Virginia

Charlottesville

VA

Раскрытие информации

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

Раскрытие информации

NM is an author of a study referenced in this topic.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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. Аннотация

Noonan TJ, Garrett WE Jr. Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg. 1999;7:262-269. Аннотация

Speer KP, Lohnes J, Garett WE Jr. Radiographic imaging of muscle strain injury. Am J Sports Med. 1993;21:89-95. Аннотация

Boutin RD, Fritz RC, Steinbach LS. Imaging of sports-related muscle injuries. Radiol Clin North Am. 2002;40:333-362. Аннотация

Wexler RK. The injured ankle. Am Fam Physician. 1998;57:474-480.Полный текст  Аннотация

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.Полный текст  Аннотация

Hertel J. The role of nonsteroidal anti-inflammatory drugs in the treatment of acute soft tissue injuries. J Athl Train. 1997;32:350-358.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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