• 대한족부족관절학회지
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• 제25권1호
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• pp.6-9
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• 2021

The term chronic lateral ankle instability (CLAI) embraces a spectrum of conditions that involve functional and mechanical instability, both in athletes and lower-demand patients. The hallmarks of CLAI are recurrent sprains, persistent pain, and repeated episodes of the ankle giving way. CLAI is the main complication of acute ankle sprains, which can cause discomfort in daily and sports activity. Approximately 10% to 30% of patients with acute ligament ruptures will develop chronic instability over the course of a year from the index injury. An accurate diagnostic approach and successful treatment plan should be established based on a comprehensive understanding of the concept of functional and mechanical instability. Unfortunately, the optimal modality for the management of CLAI is unclear. Even after conservative treatment or surgical intervention, it could result in degenerative changes to the ankle joint in the long term. Thus far, the incidence of ligamentous posttraumatic ankle osteoarthritis was reported to be 13% to 78%. The mean latency time between injury and osteoarthritis was at least 10 to 34.3 years. CLAI is an important pathological condition that can cause discomfort or dysfunction in daily activity in the short term, resulting in joint destruction in the long term. Therefore, it is important to understand the various complications that can occur when CLAI is not treated properly.

• Korean Journal of Acupuncture
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• 제33권4호
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• pp.194-203
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• 2016

Objectives : The aim of this study was to observe the dose-dependent effects of bee venom (BV) pharmacopuncture on the serious ankle sprain in rats. Methods : The grade III ankle sprain was produced by surgically damaging the lateral ligaments complex of Sprague-Dawley rats. BV pharmacopuncture with the different doses($5{\mu}g/kg$, $10{\mu}g/kg$, $50{\mu}g/kg$) were treated on the different acupoints(GB34, GB39 and GB42) of the affected hind limb, respectively. By measuring foot weight bearing force ratio(FWBFR), the pain levels by ankle sprain and the pain recovery for 7 days were observed under BV pharmacopuncture on each acupoint. Results : In the normal and ankle sprained rat, the BV single administration decreased FWBFR in a dose - dependent pattern. The higher the BV dose, the higher the pain resulted in the normal and the sprained ankles. Especially, the dose - dependent effects of BV resulted in the most pronounced decrease in FWBFR in GB34. The recovery of FWBFR was shown at the low dose($5{\mu}g/kg$) BV and the effect was most remarkable in the BV of GB34, but the others showed no recovery effect compared with the control group. Conclusions : BV pharmacopuncture does not exhibit analgesic effects in acute phase of ankle sprain. However, the recovery of ankle sprain was more effective than the natural recovery in the case of low dose of BV repeated over time. Considering this, it is presumed that it would be important to select appropriate clinic guidelines for acute phase of ankle sprain.

• Korean Journal of Acupuncture
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• 제23권2호
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• pp.113-123
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• 2006

Objectives: Pharmacopuncture which is a combination of acupuncture and herbal medicine helps to prevent and treat the diseases and symptoms including various pains. However, little was known about the therapeutic effects and its mechanisms on acute pain, although pharmacopuncture has been used frequently in acupuncture clinics. Acupuncture is known for producing analgesia for persistent ankle sprain pain in human. Furthermore, it also produces analgesia in a rat model of ankle sprain pain. Methods: To illuminate the underlying mechanisms of capsaicin pharmacopuncture-induced analgesia, weight bearing force (WBF) was observed on the acute ankle sprained rat model. Ankle sprain was induced in the rat by manually hyper-extending ligaments of the right ankle. Capsaicin pharmacopuncture was applied to SI6 (Yanglo) on the left forelimb (contralateral to the sprained ankle). Results: In behavioral test, capsaicin pharmacopuncture produced marked analgesic effects on acute ankle sprained animals as measured by WBF of the affected limb similar to manual acupuncture. Capsaicin pharmacopuncture was also suppressed by serotonin (5-HT) receptor antagonist methysergide (2 mg/kg, Lp.), but not by opioids receptor antagonist naltrexone (10 mg/kg, Lp.) and alpha adrenoceptor antagonist phentolamine (5 mg/kg, Lp.). Conclusion: The data suggest that capsaicin pharmacopuncture-induced analgesia is accomplished by activating the descending serotonergic inhibitory systems.

• 한방재활의학과학회지
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• 제21권4호
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• pp.181-190
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• 2011

Objectives: The purpose of this study is to investigate the clinical effects of heating-conduction acupuncture therapy on anterior talofibular ligament injury induced by acute and chronic ankle sprain. Methods: From April 19, 2010 to May 30, 2011 the 79 outpatients who had admitted to department of oriental rehabilitation medicine, Dae-Jeon oriental medical hospital, Dae-Jeon university with ankle sprain were performed heating-conduction acupuncture therapy on anterior taIofibular ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied before treatment and after 1st, 2nd treatment. Results: 1. The pain threshold and VAS score showed significant improvement on acute subacute, chronic anterior talofibular ligament injury group. 2. The difference in pain threshold and VAS score between acute, subacute, chronic phase group was not significant. Conclusions: Heating-conduction acupuncture therapy has clinical effects of pan reduction on patient with anterior talofibular ligament injury.

• 대한족부족관절학회지
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• 제19권3호
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• pp.81-85
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• 2015

Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.

• 대한족부족관절학회지
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• 제7권1호
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• pp.78-82
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• 2003

Purpose: The purpose of the study is to evaluate the clinical outcomes of acute achilles tendon rupture patients treated by early mobilization after operative repair. Materials and Methods: In this retrospective study, 12 patients of acute Achilles tendon rupture were surgically treated from May 2001 to November 2002, with follow-up period of at least 6 months. There were 10 men and 2 women, and mean age was 35.9 year. The repair method was single Krackow suture technique. Two to three weeks after the operation, early ROM with removable ankle-foot orthosis(AFO) was started. We used Amer-Lindholm scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. Results: We had 11 excellent results(92%), and 1 good results(8%). One-leg heel raising was possible in all patients. All the patients returned to the preinjury occupations and 7 patients(58%) reached the preoperative level of sports activities. There was no significant difference in ankle ROM and ankle plantar flexion isokinetic strength compared to contralateral side. There was, no reruptures. Conclusion: Early mobilization proved to be a well tolerated, safe, and effective means for the compliant patient.

• 한방재활의학과학회지
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• 제24권1호
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• pp.119-123
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• 2014

The purpose of this study is to report the effect of combined acupuncture treatment on acute ankle sprain patients. The subjects included in this study were 15 acute ankle sprain patients who visited Jaseng Hospital of Korean Medicine from Oct. 15th, 2012 to Feb. 8th, 2013. We treated 15 patients with combined acupuncture treatment. The treatment consisted of Hwangrunhaedok-tang (Huanglianjiedutang) pharmacupuncture, electroacupuncture (applied to GB39, ST36 on the affected side), acupuncture (applied to TE17, SI6 on the unaffected side with Dong-Qi therapy). To assess the effect of treatment, the numeric rating scale (NRS) was applied before and after treatment. After first combined acupuncture treatment, the NRS scores significantly decreased from $8.33{\pm}0.94$ to $2.26{\pm}0.44$ (p<0.01). We suggested that Combined acupuncture treatment are effective and useful on acute ankle sprain. And, further studies will be needed.

• 대한물리의학회지
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• 제13권3호
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• pp.67-73
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• 2018

PURPOSE: This study was conducted to investigate the effects of pain, balance, and left / right step time difference between elastic taping and non-elastic taping in patients with acute ankle sprain. METHODS: The subjects were patients with acute ankle sprains who had been injured within 1 day. A total of 30 subjects were divided into three groups (CG: control group, EG1: experimental group 1, EG2: experimental group 2) of 10 people. The intervention period was 3 days. In the CG, only physical therapy (cryotherapy+pulsed ultrasound) was performed, while physical therapy and elastic taping were applied in EG 1 and physical therapy and non-elastic taping were applied in EG 2. RESULTS: Changes in pain, balance and left / right step time difference following intervention decreased significantly in all three groups. After intervention, the balance between the groups differed significantly between the CG and the EGs. In addition, the left / right step time difference differed significantly between the CG and EGs, as well as between the EG 1 and the EG 2. CONCLUSION: Physiotherapy is helpful for treatment of pain associated with acute ankle sprain. Taping is considered to be a way to provide more balance and gait ability.

• 한방재활의학과학회지
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• 제20권3호
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• pp.119-129
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• 2010

Objectives : The purpose of this study is to investigate the clinical effects of heating-conduction acupuncture therapy on ligament injury induced by acute ankle sprain. Methods : From september 16, 2008 to April 17, 2010, the 28 outpatients who had admitted to department of oriental rehabilitation medicine, Dae-Jeon oriental Medical hospital, Dae-Jeon university with acute ankle sprain were performed heating-conduction acupuncture therapy on anterior talofibular and calcaneofibular ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied before treatment and after 1st, 2nd treatment. Results : 1. The pain threshold and the VAS score showed statistical significant improvement after 1st treatment on calcaneofibular and anterior talofibular ligament injury. 2. The VAS score after 2nd treatment on calcaneofibular and anterior talofibular ligament injury showed statistical significant improvement compared with that after 1st treatment. 3. The pain threshold after 2nd treatment on calcaneofibular and anterior talofibular ligament injury did not show statistical significant improvement compared with that after 1st treatment. 4. The difference between anterior talofibular and calcaneofibular ligament injury was not statistical significant in pain threshold and VAS score. Conclusions : Heating-conduction acupuncture therapy has clinical effects of pain reduction on patient with calcaneofibular ligament injury as well as anterior talofibular ligament induced by acute ankle sprain.

• 대한족부족관절학회지
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• 제16권1호
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• pp.9-18
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• 2012

Osteochondral lesions of the talus are isolated cartilage and/or bone lesions that are known cause of chronic ankle pain. They can occur as the result of a single acute ankle injury or from repetitive loading of the talus. Technical development in radiologic imaging and ankle arthroscopy have improved diagnostic capabilities for detecting osteochondral lesions. Characteristics which are important in assessing an osteochondral lesions include: the size, the type (chondral, subchondral, cystic), the stability, the displacement, the location, and the containment of lesion. Nonoperative treatment involving period of casting and non-weight-bearing is recommended for acute, non-displaced osteochondral lesions in select pediatric and adolescent patients. Operative treatment is recommended for unstable lesions or failed conservative management. Marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autograft or allograft, autologous chondrocyte implantation, are frequently employed. The purpose of this article is to review the historical background, etiology, classification systems, diagnostic strategies, and to describe a systematic approach to management of osteochondral lesions of the talus.