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Related Experiment Videos

[Supination trauma. A classic case].

G Möllenhoff1, J Richter, G Muhr

  • 1Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliche Kliniken Bergmannsheil Bochum.

Der Orthopade
|August 4, 1999
PubMed
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Ankle sprains, the most common ligament injuries, often involve supination. Differentiating between ligament elongation and complete rupture is crucial for effective treatment and managing ankle instability.

Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomechanics

Background:

  • Lateral ankle ligament sprains are the most frequent ligamentous injuries globally.
  • The primary mechanism involves foot supination, leading to antero-lateral rotational instability (ALRI).
  • Current classification systems (mild, moderate, severe) may lack practical clinical differentiation between ligament elongation and complete rupture.

Purpose of the Study:

  • To emphasize the clinical relevance of distinguishing between ligament elongation and complete rupture in lateral ankle sprains.
  • To highlight the biomechanical consequences of lateral ligamentous trauma, specifically ALRI.
  • To advocate for a comprehensive clinical examination beyond the distal fibula for diagnosing ankle sprains.

Main Methods:

  • Retrospective clinical study analysis (Zwipp, 1,235 patients).

Related Experiment Videos

  • Review of injury patterns, including combined ligament involvement and syndesmotic injuries.
  • Emphasis on clinical examination of specific bony and ligamentous structures.

    • Main Results:

    • In 70% of complete lateral ligament disruptions, anterior talo-navicular and fibulocalcaneal ligaments are co-involved.
    • Syndesmotic injuries occur in up to 10% of ankle sprains; deltoid ligament injuries in 2.5%.
    • Associated "supination fracture line" injuries occur in 7.4% of cases, requiring examination of the fifth metatarsal base, calcaneo-cuboideal ligament, and others.

    Conclusions:

    • Distinguishing between ligament elongation and complete rupture is of significant practical importance.
    • Comprehensive clinical assessment, including screening of the fifth metatarsal base, calcaneo-cuboideal ligament, and syndesmotic ligaments, is essential.
    • Careful clinical examination and standard two-plane radiographs are deemed sufficient for diagnosing ankle sprains and guiding functional therapy.