消防员训练致踝关节软组织损伤防治对策探讨
摘要
消防员常出现踝关节扭伤,如处理不及时或处理方案不当,部分患者出现慢性踝关节不稳,因此应加强防治。在分析消防员踝关节扭伤的机制基础上,提出消防员踝关节体格检查包括仔细望诊、触诊、确定患者负重能力和特定损伤诊断动作,其预防措施包括消防员应当树立牢固的预防训练伤理念,定期向消防员讲授踝关节的简单解剖知识,健身时加强踝部健身。消防员急性踝关节扭伤的治疗分为急性期和早期逐渐康复期,在不同阶段应当采取不同的治疗策略。
引文
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[2]牛素玲.某市219名消防员职业损伤情况调查分析[J].中国职业医学,2011,38(6):475-477.
[3]WATERMAN BR,OWENS BD,DAVEY S,et al. Theepidemiology of ankle sprains in the united states[J]. J Bone Joint Surg Am, 2010, 92(13): 2279-84.
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[5]VAN R R M,VAN O A G,BERNSEN R M D,et al. What is the clinical course of acute ankle sprains? a systematic literature review[J]. Am J Med, 2008, 121(4): 324-331.
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[7]KJAERSGAARD-ANDERSEN P, WETHELUND J O, HELMIG P, et al. The stabilizing effect of the ligamentous structures in the sinus and canalis tarsi on movements in the hindfoot:an experimental study[J]. Am J Sports Med, 1988, 16(5):512-516.
[8]SAFRAN M R,BENEDETTI R S,BARTOLOZZI A R,et al. Lateral ankle sprains: a comprehensive review: part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis[J]. Med Sci Sports Exerc,1999,31(7Suppl): 429-37.
[9]SAVAGE-ELLIOTT I, MURAWSKI C D, SMYTH N A, et al. The deltoid ligament: an in-depth review of anatomy, function, and treatment strategies[J]. Knee Surgery Sports Traumatology Arthroscopy,2013,21(6):1316-1327.
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[12]ZALAVRAS C, THORDARSON D. Ankle syndesmotic injury[J]. J Am Acad Orthop Surg, 2007,15(6):330-339.
[13]GALHOUM A E, WIEWIORSKI M, VALDERRABANO V. Ankle instability: anatomy, mechanics, management and sequelae[J]. Sports Orthopaedics & Traumatology,2017,33(1):47-56.
[14]FRIGG A, MAGERKURTH O, VALDERRABANO V, et al. The effect of osseous ankle configuration on chronic ankle instability[J]. British Journal of Sports Medicine,2007,41(7):420-424.
[15]SMANAD,HILLER C E,REFSHAUGE K M. Diagnostic accuracy of clinical tests for diagnosis of ankle syndesmosis injury: a systematic review[J]. Br J Sports Med, 2013, 47(10): 620-628.
[16]FERRAN N A, MAFFULLI N. Epidemiology of sprains of the lateral ankle ligament complex[J]. Foot & Ankle Clinics of North America,2006,11(3):659-662.
[17]BEKEROM P J D M,KERKHOFFS M M J G,MCCOLLUM A G,et al. Management of acute lateral ankle ligament injury in the athlete[J]. Knee Surgery, Sports Traumatology, Arthroscopy, 2013, 21(6): 1390-1395.
[18]GüN C, UNLüER E E, VANDENBERK N, et al. Bedside ultrasonography by emergency physicians for anterior talofibular ligament injury[J]. Journal of Emergencies Trauma & Shock,2013,6(3):195-8.
[19]PETERS J W, TREVIMO S G, RENSTROM P A. Chronic lateral ankle instability[J]. Foot & Ankle, 1991, 12(3):182-91.
[20]VAN DIJK C N, LONGO U G, LOPPINI M, et al. Classification and diagnosis of acute isolated syndesmotic injuries: ESSKA-AFAS consensus and guidelines[J]. Knee Surgery Sports Traumatology Arthroscopy, 2016, 24(4):1200-1216.
[21]CALDER J D, BAMFORD R, PETRIE A, et al. Stable versus unstable grade Ⅱ high ankle sprains: a prospective study predicting the need for surgical stabilization and time to return to sports[J]. Arthroscopy the Journal of Arthroscopic & Related Surgery,2016,32(4):634-642.
[22]陈爱宝,穆继宏,龚琦,等.不同处理原则对官兵踝关节扭伤后功能恢复的比较[J].华南国防医学杂志,2015,29(12):918-920.
[23]KNUPP M, LANG T H, ZWICKY L, et al. Chronic ankle instability (Medial and Lateral) [J].Clinics in Sports Medicine, 2015, 34(4):679-688.
[2]牛素玲.某市219名消防员职业损伤情况调查分析[J].中国职业医学,2011,38(6):475-477.
[3]WATERMAN BR,OWENS BD,DAVEY S,et al. Theepidemiology of ankle sprains in the united states[J]. J Bone Joint Surg Am, 2010, 92(13): 2279-84.
[4]GERBER J P,WILLIAMS G N,SCOVILLE C R,et al. Persistent disability associated with ankle sprains: a prospective examination of an athletic population[J]. Foot Ankle Int, 1998, 19(10): 653-660.
[5]VAN R R M,VAN O A G,BERNSEN R M D,et al. What is the clinical course of acute ankle sprains? a systematic literature review[J]. Am J Med, 2008, 121(4): 324-331.
[6]CZAJKA C M, TRAN E, CAI A N, et al. Ankle sprains and instability[J]. Medical Clinics of North America,2014,98(2):313-329.
[7]KJAERSGAARD-ANDERSEN P, WETHELUND J O, HELMIG P, et al. The stabilizing effect of the ligamentous structures in the sinus and canalis tarsi on movements in the hindfoot:an experimental study[J]. Am J Sports Med, 1988, 16(5):512-516.
[8]SAFRAN M R,BENEDETTI R S,BARTOLOZZI A R,et al. Lateral ankle sprains: a comprehensive review: part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis[J]. Med Sci Sports Exerc,1999,31(7Suppl): 429-37.
[9]SAVAGE-ELLIOTT I, MURAWSKI C D, SMYTH N A, et al. The deltoid ligament: an in-depth review of anatomy, function, and treatment strategies[J]. Knee Surgery Sports Traumatology Arthroscopy,2013,21(6):1316-1327.
[10]O′LOUGHLIN P F, MURAWSKI C D, EGAN C, et al. Ankle instability in sports[J].Phys Sportsmed,2009,37(2):93-103.
[11]BOYTIM M J, FISCHER D A, NEUMANN L. Syndesmotic ankle sprains[J]. American Journal of Sports Medicine,1991,19(3):294-298.
[12]ZALAVRAS C, THORDARSON D. Ankle syndesmotic injury[J]. J Am Acad Orthop Surg, 2007,15(6):330-339.
[13]GALHOUM A E, WIEWIORSKI M, VALDERRABANO V. Ankle instability: anatomy, mechanics, management and sequelae[J]. Sports Orthopaedics & Traumatology,2017,33(1):47-56.
[14]FRIGG A, MAGERKURTH O, VALDERRABANO V, et al. The effect of osseous ankle configuration on chronic ankle instability[J]. British Journal of Sports Medicine,2007,41(7):420-424.
[15]SMANAD,HILLER C E,REFSHAUGE K M. Diagnostic accuracy of clinical tests for diagnosis of ankle syndesmosis injury: a systematic review[J]. Br J Sports Med, 2013, 47(10): 620-628.
[16]FERRAN N A, MAFFULLI N. Epidemiology of sprains of the lateral ankle ligament complex[J]. Foot & Ankle Clinics of North America,2006,11(3):659-662.
[17]BEKEROM P J D M,KERKHOFFS M M J G,MCCOLLUM A G,et al. Management of acute lateral ankle ligament injury in the athlete[J]. Knee Surgery, Sports Traumatology, Arthroscopy, 2013, 21(6): 1390-1395.
[18]GüN C, UNLüER E E, VANDENBERK N, et al. Bedside ultrasonography by emergency physicians for anterior talofibular ligament injury[J]. Journal of Emergencies Trauma & Shock,2013,6(3):195-8.
[19]PETERS J W, TREVIMO S G, RENSTROM P A. Chronic lateral ankle instability[J]. Foot & Ankle, 1991, 12(3):182-91.
[20]VAN DIJK C N, LONGO U G, LOPPINI M, et al. Classification and diagnosis of acute isolated syndesmotic injuries: ESSKA-AFAS consensus and guidelines[J]. Knee Surgery Sports Traumatology Arthroscopy, 2016, 24(4):1200-1216.
[21]CALDER J D, BAMFORD R, PETRIE A, et al. Stable versus unstable grade Ⅱ high ankle sprains: a prospective study predicting the need for surgical stabilization and time to return to sports[J]. Arthroscopy the Journal of Arthroscopic & Related Surgery,2016,32(4):634-642.
[22]陈爱宝,穆继宏,龚琦,等.不同处理原则对官兵踝关节扭伤后功能恢复的比较[J].华南国防医学杂志,2015,29(12):918-920.
[23]KNUPP M, LANG T H, ZWICKY L, et al. Chronic ankle instability (Medial and Lateral) [J].Clinics in Sports Medicine, 2015, 34(4):679-688.