{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T14:31:27Z","timestamp":1756996287042},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum RWTH Aachen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Unfallchirurgie"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Die Distorsion des oberen Sprunggelenks (OSG) ist eine der h\u00e4ufigsten Verletzungen des Bewegungsapparates. Das Verletzungsmuster bestimmt die zu w\u00e4hlende Therapie und ist entscheidend f\u00fcr das Outcome. <jats:italic>Die isolierte Ruptur<\/jats:italic><jats:italic> des Au\u00dfenbandapparates ist die h\u00e4ufigste strukturelle Verletzung.<\/jats:italic> Hierf\u00fcr wird leitliniengerecht eine konservative Therapie empfohlen, f\u00fcr Kombinationsverletzungen besteht hingegen hinsichtlich des diagnostischen und therapeutischen Vorgehens keine einheitliche Vorgehensweise. Ziel der bundesweiten Umfrage war es, einen \u00dcberblick \u00fcber die aktuelle diagnostische Strategie und die g\u00e4ngigen therapeutischen Konzepte in Deutschland zu gewinnen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material und Methoden<\/jats:title>\n                <jats:p>Mitglieder der Deutschen Gesellschaft f\u00fcr Orthop\u00e4die und Unfallchirurgie (DGOU) wurden eingeladen, an einer online Umfrage zum diagnostischen und zum therapeutischen Vorgehen bei OSG-Distorsion mit einem Fragebogen, bestehend aus 20\u00a0Fragen, teilzunehmen. Neben Fragen zur Fachrichtung und zum T\u00e4tigkeitsfeld wurden die Teilnehmer gebeten, ihr diagnostisches und therapeutisches Vorgehen darzustellen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Insgesamt nahmen 806 Teilnehmer an der Umfrage teil. Die Mehrzahl der Befragten waren Orthop\u00e4den und Unfallchirurgen und in der Klinik t\u00e4tig. Bei der Erstvorstellung werden der Schubladen Test (89,5\u202f%) und der Inversions\u2011\/Eversionstest (81,6\u202f%) am h\u00e4ufigsten durchgef\u00fchrt. Eine R\u00f6ntgenuntersuchung f\u00fchren 88,1\u202f% regelhaft bei Erstvorstellung durch, 26,5\u202f% auch eine sonographische Untersuchung. Die isolierte Verletzung des Lig.\u00a0fibulotalare anterius (LFTA) behandeln 99,7\u202f% konservativ, in 78,8\u202f% der F\u00e4lle mit Vollbelastung in der Orthese. Die vollst\u00e4ndige Au\u00dfenbandruptur w\u00fcrden 79,9\u202f% konservativ behandeln. Eine kombinierte Au\u00dfenbandruptur mit Syndesmosenverletzung w\u00fcrden 30,1\u202f% der Befragten konservativ behandeln.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Diskussion<\/jats:title>\n                <jats:p>Aufgrund der Heterogenit\u00e4t der Verletzungsmuster nach einer OSG-Distorsion bestehen keine einheitlichen diagnostischen und therapeutischen Behandlungsempfehlungen. Die Ottawa Ankle Rules und die Sonographie werden trotz der guten Studienlage nur wenig eingesetzt. Die isolierte LFTA-Ruptur wird von einem Gro\u00dfteil der Befragten leitliniengerecht diagnostiziert und behandelt. Bei kombinierten Verletzungen des Innen- und Au\u00dfenbandapparates entscheidet sich die Mehrheit f\u00fcr ein konservatives Vorgehen, was durch die Literatur bei geringer Evidenz als gerechtfertigt erscheint. Kombinierte Verletzungen der Syndesmose und des Au\u00dfenbandapparates w\u00fcrde die Mehrzahl der Befragten operativ behandeln, was ebenfalls mit den Empfehlungen der Literatur korreliert. Der Versorgungsstandard in Deutschland entspricht somit weitgehend den Literaturempfehlungen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphic abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00113-024-01428-y","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T10:32:06Z","timestamp":1713436326000},"page":"449-456","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Aktuelle Diagnostik und Behandlung der Sprunggelenks-Distorsion in Deutschland","Current diagnostics and treatment of ankle sprains in German"],"prefix":"10.1007","volume":"127","author":[{"given":"Philipp","family":"Lichte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Otto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Bl\u00e4sius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Gutteck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Hildebrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dariusch","family":"Arbab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"issue":"8","key":"1428_CR1","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1007\/s00402-013-1742-5","volume":"133","author":"W Petersen","year":"2013","unstructured":"Petersen\u00a0W et\u00a0al (2013) Treatment of acute ankle ligament injuries: a\u00a0systematic review. Arch Orthop Trauma Surg 133(8):1129\u20131141","journal-title":"Arch Orthop Trauma Surg"},{"issue":"8","key":"1428_CR2","first-page":"652","volume":"51","author":"A Fuchs","year":"2022","unstructured":"Fuchs\u00a0A et\u00a0al (2022) Reality of care of patella stabilizing operations : A\u00a0status quo among active members of the German Society for Orthopedic and Trauma Surgery (DGOU). Orthopadie 51(8):652\u2013659","journal-title":"Orthopadie"},{"issue":"13","key":"1428_CR3","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.2106\/JBJS.I.01537","volume":"92","author":"BR Waterman","year":"2010","unstructured":"Waterman\u00a0BR et\u00a0al (2010) The epidemiology of ankle sprains in the United States. J\u00a0Bone Joint Surg Am 92(13):2279\u20132284","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"1428_CR4","doi-asserted-by":"publisher","first-page":"361","DOI":"10.2165\/00007256-200029050-00005","volume":"29","author":"J Hertel","year":"2000","unstructured":"Hertel\u00a0J (2000) Functional Instability Following Lateral Ankle Sprain. Sports Med 29(5):361\u2013371","journal-title":"Sports Med"},{"issue":"1","key":"1428_CR5","doi-asserted-by":"publisher","first-page":"73","DOI":"10.2165\/00007256-200737010-00006","volume":"37","author":"DT-P Fong","year":"2007","unstructured":"Fong\u00a0DT\u2011P et\u00a0al (2007) A\u00a0Systematic Review on Ankle Injury and Ankle Sprain in Sports. Sports Med 37(1):73\u201394","journal-title":"Sports Med"},{"key":"1428_CR6","unstructured":"AWMF-S1 Leitlinie: Frische Au\u00dfenbandruptur am Oberen Sprunggelenk. Arbeitsgemeinschaft Wiss Med Fachgesellschaften AWMF-St\u00e4ndige Komm Leitlinien. www.deutsches-fusszentrum-richter.de\/sitesmedia\/rummelsberg\/downloads\/01_medizin-pflege\/fachabteilungen\/fuss\/merkblaetter_richter\/leitlinie_osg.pdf. Zugegriffen: 22.03.2024"},{"issue":"6","key":"1428_CR7","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1302\/0301-620X.78B6.0780958","volume":"78b","author":"CN vanDijk","year":"1996","unstructured":"vanDijk\u00a0CN et\u00a0al (1996) Physical examination is sufficient for the diagnosis of sprained ankles. J\u00a0Bone Joint Surg Br 78b(6):958\u2013962","journal-title":"J Bone Joint Surg Br"},{"issue":"1","key":"1428_CR8","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1186\/s12891-021-03998-z","volume":"22","author":"M Wenning","year":"2021","unstructured":"Wenning\u00a0M et\u00a0al (2021) Clinical evaluation of manual stress testing, stress ultrasound and 3D stress MRI in chronic mechanical ankle instability. BMC Musculoskelet Disord 22(1):198","journal-title":"BMC Musculoskelet Disord"},{"issue":"6","key":"1428_CR9","doi-asserted-by":"publisher","first-page":"566","DOI":"10.3109\/17453679608997757","volume":"67","author":"CN van Dijk","year":"1996","unstructured":"van Dijk\u00a0CN et\u00a0al (1996) Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma. Acta Orthop Scand 67(6):566\u2013570","journal-title":"Acta Orthop Scand"},{"issue":"12","key":"1428_CR10","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.3113\/FAI.2011.1110","volume":"32","author":"PC de Cesar","year":"2011","unstructured":"de Cesar\u00a0PC, Avila\u00a0EM, de Abreu\u00a0MR (2011) Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot Ankle Int 32(12):1110\u20131114","journal-title":"Foot Ankle Int"},{"issue":"5","key":"1428_CR11","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1136\/bjsports-2013-092787","volume":"49","author":"AD Sman","year":"2015","unstructured":"Sman\u00a0AD et\u00a0al (2015) Diagnostic accuracy of clinical tests for ankle syndesmosis injury. Br J Sports Med 49(5):323\u2013329","journal-title":"Br J Sports Med"},{"issue":"6","key":"1428_CR12","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1136\/bjsports-2016-096858","volume":"51","author":"PR Beckenkamp","year":"2017","unstructured":"Beckenkamp\u00a0PR et\u00a0al (2017) Diagnostic accuracy of the Ottawa Ankle and Midfoot Rules: a\u00a0systematic review with meta-analysis. Br J Sports Med 51(6):504\u2013510","journal-title":"Br J Sports Med"},{"issue":"7","key":"1428_CR13","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1007\/s001130170092","volume":"104","author":"A Chandra","year":"2001","unstructured":"Chandra\u00a0A, Schafmayer\u00a0A (2001) Diagnostic value of a\u00a0clinical test for exclusion of fractures after acute ankle sprains. A\u00a0prospective study for evaluating the \u201dOttowa Ankle Rules\u201c in Germany. Unfallchirurg 104(7):617\u2013621","journal-title":"Unfallchirurg"},{"issue":"3","key":"1428_CR14","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.fuspru.2016.05.002","volume":"14","author":"H Gaulrapp","year":"2016","unstructured":"Gaulrapp\u00a0H, Lins\u00a0S, Walther\u00a0M (2016) M\u00f6glichkeiten der funktionellen sonografischen Diagnostik bei der Prim\u00e4rbehandlung fibularer Kapsel-Band-Verletzungen des Sprunggelenks. Fu\u00df Sprunggelenk 14(3):137\u2013145","journal-title":"Fu\u00df Sprunggelenk"},{"key":"1428_CR15","doi-asserted-by":"crossref","unstructured":"Chun DI et\u00a0al (2019) Diagnostic Accuracy of Radiologic Methods for Ankle Syndesmosis Injury: A\u00a0Systematic Review and Meta-Analysis. J\u00a0Clin Med 8(7)","DOI":"10.3390\/jcm8070968"},{"key":"1428_CR16","unstructured":"Weber CD et\u00a0al (2021) Osteochondral lesions of the talus : Individualized approach based on established and innovative reconstruction techniques. Unfallchirurg"},{"issue":"11","key":"1428_CR17","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1007\/s00167-008-0607-x","volume":"16","author":"K-B Lee","year":"2008","unstructured":"Lee\u00a0K\u2011B et\u00a0al (2008) A\u00a0comparison of arthroscopic and MRI findings in staging of osteochondral lesions of the talus. Knee Surg Sports Traumatol Arthrosc 16(11):1047\u20131051","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"Suppl 2","key":"1428_CR18","first-page":"1","volume":"101","author":"M Posadzy","year":"2017","unstructured":"Posadzy\u00a0M, Desimpel\u00a0J, Vanhoenacker\u00a0F (2017) Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. J\u00a0Belg Soc Radiol 101(Suppl 2):1","journal-title":"J Belg Soc Radiol"},{"key":"1428_CR19","doi-asserted-by":"crossref","unstructured":"Kerkhoffs GM et\u00a0al (2007) Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults. Cochrane Database Syst Rev (2):CD380","DOI":"10.1002\/14651858.CD000380.pub2"},{"issue":"14","key":"1428_CR20","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.2106\/JBJS.I.01176","volume":"92","author":"H Pihlajam\u00e4ki","year":"2010","unstructured":"Pihlajam\u00e4ki\u00a0H et\u00a0al (2010) Surgical versus functional treatment for acute ruptures of the lateral ligament complex of the ankle in young men: a\u00a0randomized controlled trial. J\u00a0Bone Joint Surg Am 92(14):2367\u20132374","journal-title":"J Bone Joint Surg Am"},{"issue":"2","key":"1428_CR21","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1136\/bjsports-2016-096178","volume":"51","author":"C Doherty","year":"2017","unstructured":"Doherty\u00a0C et\u00a0al (2017) Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med 51(2):113\u2013125","journal-title":"Br J Sports Med"},{"issue":"8","key":"1428_CR22","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1080\/02640414.2014.964751","volume":"33","author":"T Winter","year":"2015","unstructured":"Winter\u00a0T et\u00a0al (2015) Influence of a\u00a0proprioceptive training on functional ankle stability in young speed skaters\u2014a\u00a0prospective randomised study. J\u00a0Sports Sci 33(8):831\u2013840","journal-title":"J Sports Sci"},{"issue":"5","key":"1428_CR23","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1055\/s-0031-1280258","volume":"149","author":"S Rammelt","year":"2011","unstructured":"Rammelt\u00a0S et\u00a0al (2011) Ligamentous injuries to the ankle joint. Z\u00a0Orthop Unfall 149(5):e45\u2013e67","journal-title":"Z Orthop Unfall"},{"key":"1428_CR24","doi-asserted-by":"crossref","unstructured":"Toohey JS, Worsing RA Jr. (1989) A\u00a0long-term follow-up study of tibiotalar dislocations without associated fractures. Clin Orthop Relat Res (239):207\u2013210","DOI":"10.1097\/00003086-198902000-00023"},{"key":"1428_CR25","doi-asserted-by":"crossref","unstructured":"Lima AGDB, Filho JCP, Barbosa GMR (2018) Tibiotalar dislocation without associated fractures : a\u00a0case report.","DOI":"10.30795\/2595-1459.2018.v1211"},{"issue":"10","key":"1428_CR26","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.1016\/j.injury.2017.08.011","volume":"48","author":"L Wight","year":"2017","unstructured":"Wight\u00a0L et\u00a0al (2017) Pure Ankle Dislocation: A\u00a0systematic review of the literature and estimation of incidence. Injury 48(10):2027\u20132034","journal-title":"Injury"},{"issue":"10","key":"1428_CR27","doi-asserted-by":"publisher","first-page":"2617","DOI":"10.1177\/03635465231181082","volume":"51","author":"AW Brady","year":"2023","unstructured":"Brady\u00a0AW et\u00a0al (2023) The Biomechanical Role of the Deltoid Ligament on Ankle Stability: Injury, Repair, and Augmentation. Am J Sports Med 51(10):2617\u20132624","journal-title":"Am J Sports Med"},{"issue":"6","key":"1428_CR28","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s00068-014-0466-8","volume":"41","author":"S Rammelt","year":"2015","unstructured":"Rammelt\u00a0S, Obruba\u00a0P (2015) An update on the evaluation and treatment of syndesmotic injuries. Eur J Trauma Emerg Surg 41(6):601\u2013614","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"4","key":"1428_CR29","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1007\/s00167-016-4017-1","volume":"24","author":"CN van Dijk","year":"2016","unstructured":"van Dijk\u00a0CN et\u00a0al (2016) Conservative and surgical management of acute isolated syndesmotic injuries: ESSKA-AFAS consensus and guidelines. Knee Surg Sports Traumatol Arthrosc 24(4):1217\u20131227","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"10","key":"1428_CR30","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1177\/107110079801901002","volume":"19","author":"JP Gerber","year":"1998","unstructured":"Gerber\u00a0JP et\u00a0al (1998) Persistent disability associated with ankle sprains: a\u00a0prospective examination of an athletic population. Foot Ankle Int 19(10):653\u2013660","journal-title":"Foot Ankle Int"},{"issue":"2","key":"1428_CR31","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00142-015-0014-5","volume":"28","author":"E Orthner","year":"2015","unstructured":"Orthner\u00a0E, Buchhorn\u00a0T (2015) Komplexe Sprunggelenksinstabilit\u00e4ten mit Syndesmosenverletzung und deren Therapie. Arthroskopie 28(2):137\u2013141","journal-title":"Arthroskopie"}],"container-title":["Die Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00113-024-01428-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00113-024-01428-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00113-024-01428-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T08:02:15Z","timestamp":1716883335000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00113-024-01428-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,18]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["1428"],"URL":"https:\/\/doi.org\/10.1007\/s00113-024-01428-y","relation":{},"ISSN":["2731-7021","2731-703X"],"issn-type":[{"value":"2731-7021","type":"print"},{"value":"2731-703X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,18]]},"assertion":[{"value":"23 February 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 April 2024","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"P.\u00a0Lichte, Weber, Otto, Bl\u00e4sius, Gutteck, Hildebrand und Arbab geben an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autor\/-innen keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}