目的:探索患病率,青年大学生踝关节扭伤的危险因素及治疗,以获得准确的流行病学数据。
方法:从2019年3月至2019年5月,根据纳入和排除标准,招募了来自西安体育大学的552名大学生(1104个关节的侧面)。其中男性309例,女性243例,年龄16~24岁,平均(20.9±3.7)岁。年龄,性别,并记录体重指数(BMI)等。体育学生急性和慢性踝关节扭伤的发病率,第一次扭伤后的治疗(冷敷,石膏或石膏支撑和药物),通过踝关节扭伤问卷评估行走过程中的视觉模拟量表(VAS);坎伯兰踝关节不稳定工具(CAIT),马里兰足部评分用于评估踝关节功能。通过肌肉骨骼超声检查客观评估踝关节外侧韧带损伤。
结果:急性踝关节扭伤(AAS)的患病率为96.20%(531/552),AAS的发生率为59.96%(622/1104)。慢性踝关节不稳定(CAI)的患病率为16.85%(93/552),CAI发生率为8.97%(99/1104)。在四类体育中,表现专业组的大学生遭受多次扭伤的比例为22.20%(14/63),包括有氧和舞蹈表演。球类运动AAS的发生率为8.60%(14/163)。第一次扭伤后,大多数大学生(94.4%)接受了冷压缩,大约60%的人去了医院;然而,只有44.7%的学生接受了标准治疗(石膏或石膏),只有35.3%的患者接受了硬踝关节矫形器。在552名大学生中,44名学生脚踝扭伤超过4次,总发生率为7.97%(44/552)。坎伯兰得分为26.6±2.4,学生踝关节扭伤4次以上的坎伯兰得分为(29.2±1.1),提示这是踝关节不稳定的危险因素。学生踝关节扭伤4次以上的VAS高于4次以下的VAS(P<0.05),马里兰足评分显著低于<4倍(P<0.05)。肌骨超声测量胫腓前韧带(ATFL)厚度为(2.41±0.41)mm,后腓骨韧带(CFL)厚度为(1.92±0.21)mm,差异无统计学意义(P>0.05)。
结论:94%的大学生至少有一次脚踝扭伤,踝关节扭伤在有氧运动和球类运动中更为常见。第一次扭伤后,铸型或石膏处理的比例低于50%。踝关节扭伤4次以上是危险因素,肌肉骨骼超声检查显示ATFL和CFL增厚,虽然没有政治上的区别。
OBJECTIVE: To explore prevalence, risk factors and treatment of ankle
sprain of young college student , in order to obtain accurate epidemiological data.
METHODS: From March 2019 to May 2019, 552 college students(1 104 sides of anke joints) from Xi\'an Physical Education university were enrolled in study according to inclusion and excludion standard, including 309 males and 243 females aged from 16 to 24 years old with an average of (20.9±3.7) years old. Age, gender, and body mass indes(BMI) etc were recorded. Morbidity of acute and chronic ankle sprains of physical students, treatment after the first
sprain (cold compress, cast or plaster bracing and medicine), visual analogue scale (VAS) during walking were assessed through ankle sprain questionnaire;Cumberland ankle instability tool (CAIT), Maryland foot score were applied to assess ankle function. Lateral ankle ligament injury was objectively assessed by musculoskeletal ultrasonography.
RESULTS: The prevalence of acute ankle
sprain(AAS) was 96.20% (531/552), and the incidence of AAS was 59.96% (622/1 104). The prevalence of chronic ankle joint instability(CAI) was 16.85% (93/552), and the incidence of CAI was 8.97% (99/1 104). In the four categories of sports, college student suffered from multiple sprains in performance majors group was 22.20% (14/63), including of aerobicsand dance performance. The incidence of AAS of ball sports was 8.60%(14/163). After the first
sprain, most college students(94.4%) were received cold compression, about 60% of them went to hospital;however, only 44.7% students were received standard treatmens(cast or plaster), only 35.3% of them were received hard ankle orthosis. In 552 college students, 44 students were suffered from more than 4 times of ankle sprain, and the total incidence was 7.97% (44/552). Cumberland score was 26.6±2.4, Cumberland score of students sprained ankle joint more than 4 times was (29.2±1.1), suggested it was a risk factor for ankle joint instability. VAS of students sprained ankle joint more than 4 times was higher than that of less than 4 times(P<0.05), Maryland foot score was significantly lower than that of that of <4 times(P<0.05). Musculoskeletal ultrasonography measured the thickness of anterior tibiofibular ligament(ATFL) was (2.41±0.41) mm, and the thickness of calcaneofibular ligament(CFL) was (1.92±0.21) mm, and had no statistical difference(P>0.05).
CONCLUSIONS: Ninty-four percent college students had at least once ankle sprain, ankle sprains were more common in erobics and ball sports. After the first
sprain, the proportion of cast or plaster treatment was less than 50%. Sprained ankle joint more than 4 times is a risk factor, and musculoskeletal ultrasonography showed thickening of both ATFL and CFL, while no statstical difference.