英汉对照骨科患者指南006：踝关节扭伤（上）
Ankle Sprain
踝关节扭伤
A Patient’s Guide to Ankle Sprain
踝关节扭伤患者指南
Introduction
简介
踝关节扭伤是生活中很常见的损伤，通常是由于踝关节内翻损伤所导致。术语“扭伤”一般指的是软组织的损伤，在踝关节，通常指的是韧带损伤。
This guide will help you understand
how an ankle sprain occurs
how doctors diagnose the condition
what can be done to treat a sprain
本指南旨在帮助你了解
踝关节扭伤是怎样发生的
如何诊断踝关节扭伤
如何治疗踝关节扭伤
Anatomy
解剖
What part of the ankle is involved?
踝关节包括哪些结构？
Ligaments are tough bands of tissue that help connect bones together. Three ligaments make up the lateral ligament complex on the side of the ankle farthest from the other ankle. They are theanterior talofibular ligament (ATFL),the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL).The common inversion injury to the ankle usually involves two ligaments, the ATFL and CFL. Normally, the ATFL keeps the ankle from sliding forward, and the CFL keeps the ankle from rolling inward on its side.
韧带是一种致密的带状组织，它把相邻骨关节连接在一起。踝关节外侧韧带复合体由三条韧带组成：距腓前韧带、跟腓韧带、距腓后韧带。踝关节内翻扭伤通常累及其中两条韧带：距腓前韧带和跟腓韧带。距腓前韧带防止踝关节前移，跟腓韧带防止踝关节过度内收。
Related Document:
相关阅读：英汉对照骨科患者指南001：踝关节解剖
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Causes
病因
Why do I have this problem?
为什么我的踝关节会扭伤？
A ligament is made up of multiple strands of connective tissue, similar to a nylon rope. A sprain results in stretching or tearing of the ligaments. Minor sprains only stretch the ligament. A tear may be either a complete tear of all the strands of the ligament or a partial tear of only some of the strands. The ligament is weakened by the injury; how much it is weakened depends on the degree of the sprain.
韧带是由多股束带状结缔组织组成，很像是一股尼龙绳。扭伤会导致韧带的拉伤或撕裂。轻微扭伤仅仅导致韧带的拉伤。严重扭伤会导致韧带撕裂，而韧带撕裂既可能是韧带内全部束带的断裂，也可能是部分束带的断裂。韧带损伤后，其力量会减弱，具体减弱的程度取决于扭伤的程度。
The lateral ligaments are by far the most commonly injured ligaments in a typical inversion injury of the ankle. In an inversion injury the ankle tilts inward, meaning the bottom of the angles toward the other foot. This forces all the pressure of your body weight onto the outside edge of the ankle. As a result, the ligaments on the outside of the ankle are stretched and possibly torn.
踝关节外侧韧带损伤最常见于踝关节内翻损伤。何谓踝关节内翻损伤？就是发生扭伤时，扭伤的这只脚的足底朝向另外一只脚，这样全身的重量都集中于踝关节的外侧，结果导致了踝关节外侧韧带的拉伤或撕裂。
A severe form of ankle sprain, called an , involves damage to other supportive ligaments in the ankle. This type of injury is sometimes called a high ankle sprain because it involves the ligaments above the. In an ankle syndesmosis injury, at least one of the ligaments connecting the tibia and fibula bones (the lower leg bones) is sprained. Recovering from even mild injuries of this type takes at least twice as long as from a typical ankle sprain.
有一种严重的踝关节扭伤，又称踝关节下胫腓联合损伤，累及踝关节的其他支持韧带。这种类型的踝关节扭伤又称高位踝关节扭伤，因为它累及的韧带位于踝关节上方。踝关节下胫腓联合损伤发生时，至少有一条连接胫腓骨远端的韧带发生拉伤或撕裂，即使是轻微的下胫腓联合损伤，其恢复时间至少是普通踝关节扭伤的两倍。
Related Document:
相关阅读：踝关节下胫腓联合损伤患者指南（待翻译，有兴趣者请留言）
Symptoms
症状
What does an ankle sprain feel like?
踝关节扭伤后有哪些表现？
Initially the ankle is swollen, painful, and may turnecchymotic (bruised). The bruising and swelling are due to ruptured blood vessels from the tearing of the soft tissues. Most of the initial swelling is actually bleeding into the surrounding tissues. The ankle swells as extra fluid continues to leak into the tissues over the 24 hours following the sprain.
踝关节扭伤发生后，最初的症状是肿胀、疼痛、淤青，这是由于撕裂的软组织内血管发生破裂，进而血液渗出到踝关节周围所致。随着扭伤后24小时或更长时间，额外的液体不断渗漏入组织，踝关节发生肿胀。
People who have sprained an ankle often end up spraining the ankle again. If the ankle keeps turning in with activity, the condition is called ankle instability. Patients who have ankle instability lose confidence in their ankle to support them, especially on uneven ground. They often have swelling around the ankle that doesn’t go away. Pain and swelling in a joint can cause a reflex where the body turns off the muscles around the joint. This can cause times when the ankle feels like it is going to give way, meaning it may have a tendency to twist again very easily.
一旦踝关节发生过一次扭伤，就很容易再次发生扭伤。如果踝关节反复多次扭伤，这被称之为“踝关节不稳”，这种情况会导致患者对他们的踝关节的功能失去信心，尤其是在凹凸不平的路面行走时。这类患者的踝关节总是反复肿胀而不能消退。关节的疼痛和肿胀会反射性地使人们不使用关节周围的肌肉。这会不时地让人们感觉踝关节似乎将要垮掉了，也说是说踝关节更容易再次扭伤。
People who have had several mild ankle sprains or one severe sprain are prone to impingement problems in the ankle. The ligaments that were sprained may become irritated and thickened, causing them to get pinched near the edge of the ankle joint.
反复多次的轻度踝关节扭伤或一次严重的踝关节扭伤均可导致踝关节撞击综合征。扭伤韧带会发炎并增厚，导致在踝关节边缘附近出现撞击。
Related Document:
相关阅读：踝关节撞击综合征患者指南（待翻译，有兴趣者请留言）
Diagnosis
诊断
How do doctors diagnose the condition?
医生是如何诊断踝关节扭伤的
The diagnosis of an ankle sprain is usually made by examination of the ankle and X-rays to make sure that the ankle is not fractured. A physical examination is used to determine which ligament has been injured. The doctor will move your ankle in different positions in order to check the ligaments and other soft tissues around the ankle. Some tests place stress directly on the ankle ligaments to see if the ankle has become unstable and to find out if one or more ligaments has been partially or completely torn.
踝关节扭伤的诊断通常是通过体格检查，然后拍摄X片排除踝关节骨折。体格检查可以判断哪一根韧带发生损伤。你的医生会在不同方向活动你的踝关节，以检查踝关节韧带和周围软组织。一些特殊的体检试验，直接把应力施加于踝关节韧带，通过踝关节的稳定程度来判断是否有韧带损伤，一根或多跟韧带损伤，是部分还是全部撕裂。
If a complete rupture of the ligaments is suspected, your doctor may order stress X-rays as well. These X-rays are taken while the ligaments are placed in a stretched position. The X-ray will show a slight tilt in the ankle bone if the ligaments have been torn.
如果你的医生怀疑你的韧带全部撕裂，他会建议你去拍摄一个应力位的X片。所谓应力位X片即你拍片时，你的踝关节会被施加一个外力，以使得韧带处于张力状态。如果存在韧带撕裂，那么在X片上会表现出踝关节骨头的轻度倾斜。
（任甜甜 译）
译者介绍：
任甜甜，主治医师，博士在读。硕士毕业于复旦大学附属华山医院。曾在英国伦敦大学学院（UCL）进修学习。宁波大学医学院留学生部讲师。参与市级课题三项，国家卫计委课题一项。获院级“十佳优秀青年医师”，院级中青年论坛一等奖，中华骨科好医生大赛浙江赛区第二名。
技术专长：手足外伤及四肢骨折的微创治疗，周围神经卡压综合征的诊治，手腕及足踝小关节炎的诊治。四肢软组织及神经肿瘤的诊治。踝关节扭伤，跟痛症，拇外翻，平足，高弓足等足部畸形的诊治。
门诊时间：周一下午、周四下午
门诊地点：宁波市第一医院1号楼4楼外科诊区
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