{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T22:24:16Z","timestamp":1766269456008,"version":"3.37.3"},"reference-count":62,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die chronische Sprunggelenkinstabilit\u00e4t l\u00e4sst sich grundlegend in 3 Komponenten unterteilen, die interagieren: die mechanische Instabilit\u00e4t, die funktionelle Instabilit\u00e4t und die\n            subjektive Instabilit\u00e4t. Die bestm\u00f6gliche Therapieempfehlung muss die dominierende \u00c4tiologie sowie das Zusammenspiel zwischen mechanischer und funktioneller Komponente ber\u00fccksichtigen.\n            Hierzu bedarf es einer ad\u00e4quaten Diagnostik, auch wenn die quantitative Diagnostik der mechanischen Instabilit\u00e4t weiterhin eine Herausforderung darstellt. Zu den diagnostischen Optionen\n            z\u00e4hlen f\u00fcr die Mechanik die klinische Untersuchung, die jedoch keine Einteilung in Schweregrade erlaubt. Weiterhin bilden die Stress-Sonografie, das 3-D-Stress-MRT (3SAM), die\n            Arthrometrie, je nach Fragestellung die markerbasierte Bewegungsanalyse und die diagnostische Sprunggelenkarthroskopie das Portfolio der diagnostischen M\u00f6glichkeiten. Letztere ist aktuell\n            der anerkannte Goldstandard, auch wenn eine rein diagnostische Arthroskopie nicht indiziert ist, es sich um ein invasives Verfahren handelt und diese ebenso wenig wie die klinische\n            Untersuchung eine Bemessung der Instabilit\u00e4t erlaubt. Zur funktionellen Diagnostik geh\u00f6ren der Star Excursion Balance Test, die Posturografie\/Stabilometrie, die Gang-\/Laufanalyse, die\n            EMG-Analyse (EMG: Elektromyografie) in der dynamischen Untersuchung und die isokinetische Kraftmessung.<\/jats:p><jats:p>Die Standardtherapie ist die konservative Behandlung mithilfe von sensomotorischem Training, Kr\u00e4ftigung der gelenkumgreifenden Muskulatur sowie der unteren Extremit\u00e4t,\n            Gleichgewichtstraining mit Gang- und Laufschule auf unterschiedlichen Untergr\u00fcnden. Jedoch wird zunehmend klar, dass ein gewisser Grad mechanischer Insuffizienz nicht durch funktionelles\n            Training kompensiert werden kann. Es ist das Ziel der differenzierten Diagnostik, diese Patienten\/-innen zu identifizieren und f\u00fcr diese die richtige mechanische Therapie zu indizieren\n            bspw. Tapeverb\u00e4nde, Sprunggelenkorthesen oder operative Bandrekonstruktion.<\/jats:p>","DOI":"10.1055\/a-1696-2503","type":"journal-article","created":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T00:12:25Z","timestamp":1644883945000},"page":"552-562","source":"Crossref","is-referenced-by-count":4,"title":["Sprunggelenk-Instabilit\u00e4t: Wie unterscheide ich mechanisch von funktionell?"],"prefix":"10.1055","volume":"161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3929-2317","authenticated-orcid":false,"given":"Markus","family":"Wenning","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-Universit\u00e4t Freiburg Medizinische Fakult\u00e4t, Freiburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagen","family":"Schmal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-Universitat Freiburg Medizinische Fakultat, Freiburg, Deutschland"},{"name":"Department of Orthopedic Surgery, Odense University Hospital Department of Orthopaedic Surgery, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.2165\/00007256-200737010-00006","article-title":"A systematic review on ankle injury and ankle sprain in sports","volume":"37","author":"DT-P Fong","year":"2007","journal-title":"Sports Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1007\/s00113-007-1310-y","article-title":"Chronische Instabilit\u00e4t des oberen Sprunggelenks","volume":"110","author":"V Valderrabano","year":"2007","journal-title":"Unfallchirurg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/j.jsams.2014.01.005","article-title":"Predictors of chronic ankle instability after an index lateral ankle sprain: A systematic review","volume":"17","author":"F Pourkazemi","year":"2014","journal-title":"J Sci Med Sport"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2095","DOI":"10.1007\/s00167-017-4556-0","article-title":"Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert","volume":"26","author":"F Michels","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1186\/s13018-020-01847-8","article-title":"Functional deficits in chronic mechanical ankle instability","volume":"15","author":"M Wenning","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1136\/bjsports-2017-098106","article-title":"Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline","volume":"52","author":"G Vuurberg","year":"2018","journal-title":"Br J Sports Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1136\/bjsports-2016-096189","article-title":"Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains","volume":"50","author":"PA Gribble","year":"2016","journal-title":"Br J Sports Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1007\/s00402-013-1742-5","article-title":"Treatment of acute ankle ligament injuries: a systematic review","volume":"133","author":"W Petersen","year":"2013","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"528","DOI":"10.4085\/1062-6050-48.4.02","article-title":"National Athletic Trainers\u2019 Association position statement: conservative management and prevention of ankle sprains in athletes","volume":"48","author":"TW Kaminski","year":"2013","journal-title":"J Athl Train"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"136","DOI":"10.4085\/1062-6050-47.2.136","article-title":"Discriminating Between Copers and People With Chronic Ankle Instability","volume":"47","author":"EA Wikstrom","year":"2012","journal-title":"J Athl Train"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.amjmed.2007.11.018","article-title":"What Is the Clinical Course of Acute Ankle Sprains? 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