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Dr. Samuel Ling -  Orthopaedic Surgeon

Translation: Stacey Yeung - Dance Science Researcher

05 February 2020

 

Ankle injuries are extremely common with >90% dancers claiming to have sustained an ankle sprain before. However, the problem is, half of the dancers ignored the injury and carried on dancing. >1/3 actually go on to develop chronic ankle instability; characterized by repeated sprains, giving way, chronic pain, and swelling. Additionally, torn outer ankle ligaments lead to destabilization of the joint, but can have good results following proper care.

For background context; the ankle (in contrast to the knee and hips) should be very resilient against arthritis and degeneration. This is reflected by the (mostly middle-aged) ankle osteoarthritis patients we see in the clinic, they often have a common medical history: a previously neglected ankle injury.

 

Treatment of ankle osteoarthritis is much more complex than the treatment of an ankle ligament tear, while end-stage arthritis often needs a metallic ankle replacement or surgical fusion of the entire joint. In contrast, acute ligament injuries often only need a short period of rest and protection followed by focused training to regain range-of-motion and strength.

Last but not least, a few weeks of proper treatment now may prevent years of trouble later.

拗柴的後果可能比你想像中嚴重

作者:凌家健醫生 - 骨科醫生

​中文翻譯:楊子慧 - 舞蹈科學研究員

超過百分之九十的舞者聲稱曾經經歷過拗柴,可見腳踝傷患極為普遍。但問題是,有一半的舞者會選擇忽略傷患並繼續跳舞。在沒有妥善處理傷患的情況下,實際上有多於三分之一的個案惡化成慢性踝關節不穩-其特點為反覆拗柴、發軟、慢性疼痛和腫脹。此外,踝外韌帶撕裂會導致踝關節不穩定,但得到正確的護理後可以達致良好的醫療效果。

 

實際上,腳踝(有別於膝蓋和臀部)對關節炎和退化應該具有很強的適應力。在診所中看到的踝骨關節炎患者(大多數為中年人士)的個案反映了這一點,而他們的病史通常都有一個共通點:有曾被忽略的腳踝傷患。

 

踝關節炎的治療比踝韌帶撕裂的治療複雜得多,而期末關節炎通常需要進行金屬關節置換或整個關節的融合手術。相反,急性韌帶損傷通常只需要短暫的休息和保護,再進行重點訓練,便可以恢復運動範圍和力量。

現在,適時地接受幾星期的妥善治療,或可免除以後纏繞多年的麻煩。

References

 

1. Li Q, Tu Y, Chen J, Shan J, Yung PS-H, Ling SK-K, et al. Reverse anterolateral drawer test is more sensitive and accurate for diagnosing

    chronic anterior talofibular ligament injury. Knee Surg Sports Traumatol Arthrosc. 2019 Sep 26;

2. Vuurberg G, Hoorntje A, Wink LM, van der Doelen BFW, van den Bekerom MP, Dekker R, 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.

3. Guillo S, Bauer T, Lee JW, Takao M, Kong SW, Stone JW, et al. Consensus in chronic ankle instability: etiology, assessment, surgical

    indications and place for arthroscopy. Orthop Traumatol Surg Res. 2013 Dec;99(8 Suppl): S411-419.

Disclaimer Statement:

This article was accomplished by the author in his/her personal capacity. The opinions expressed in this article do not reflect the view of the official statement of CUHK and HKADMS. It is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with an appropriate professional for specific advice related to your situation.

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Primary Source:  DANCE Magazine