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
Authors
Senthil N. Sambandam, MBBS, MS, MRCS(Edn)
Staff Orthopaedic Surgeon
Department of Orthopaedics
VA Medical Center
Cheyenne
WY
Disclosures
SNS declares that he has no competing interests.
Varatharaj Mounasamy, MD, FRCS
Assistant Professor
Department of Orthopaedic Surgery
Virginia Commonwealth University
Richmond
VA
Disclosures
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
Disclosures
SRM declares that he has no competing interests.
Acknowledgements
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.
Peer reviewers
Quanjun Cui, MD
Assistant Professor
Department of Orthopaedics
University of Virginia
Charlottesville
VA
Disclosures
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
გაფრთხილება:
NM is an author of a study referenced in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
წყაროები
ძირითადი სტატიები
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. აბსტრაქტი
Noonan TJ, Garrett WE Jr. Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg. 1999;7:262-269. აბსტრაქტი
Speer KP, Lohnes J, Garett WE Jr. Radiographic imaging of muscle strain injury. Am J Sports Med. 1993;21:89-95. აბსტრაქტი
Boutin RD, Fritz RC, Steinbach LS. Imaging of sports-related muscle injuries. Radiol Clin North Am. 2002;40:333-362. აბსტრაქტი
Wexler RK. The injured ankle. Am Fam Physician. 1998;57:474-480.სრული ტექსტი აბსტრაქტი
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.სრული ტექსტი აბსტრაქტი
Hertel J. The role of nonsteroidal anti-inflammatory drugs in the treatment of acute soft tissue injuries. J Athl Train. 1997;32:350-358.სრული ტექსტი აბსტრაქტი
გამოყენებული სტატიები
ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია მომხმარებლებისთვის, რომლებსაც აქვთ წვდომა BMJ Best Practice-ის ყველა ნაწილზე.
დიფერენციული დიაგნოზები
- Fracture
- Cartilage injury
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- 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
მეტი გაიდლაინებიპაციენტის ბროშურები
Ankle sprain
მეტი პაციენტის ბროშურებიშედით სისტემაში ან გამოიწერეთ BMJ Best Practice
ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას