编辑“︁扭伤”︁（章节）

== 治疗 ==
扭伤的治疗通常包括进行[[保守治疗]]以减少扭伤的体征与症状，进行手术修复严重的撕裂或断裂，以及进行康复以恢复受伤关节的功能。尽管大多数扭伤可以不用手术治疗，但根据个人情况，严重的损伤可能需要肌腱移植或韧带修复。<ref>{{Cite journal|last=Petersen|first=Wolf|last2=Rembitzki|first2=Ingo Volker|last3=Koppenburg|first3=Andreas Gösele|last4=Ellermann|first4=Andre|last5=Liebau|first5=Christian|last6=Brüggemann|first6=Gerd Peter|last7=Best|first7=Raymond|date=August 2013|title=Treatment of acute ankle ligament injuries: a systematic review|journal=Archives of Orthopaedic and Trauma Surgery|volume=133|issue=8|pages=1129–1141|doi=10.1007/s00402-013-1742-5|issn=0936-8051|pmc=3718986|pmid=23712708}}</ref> 康复的程度和时间将取决于扭伤的严重程度。<ref name=":6">{{Cite web|url=https://www.health.harvard.edu/pain/recovering_from_an_ankle_sprain|title=Recovering from an ankle sprain|last=Publishing|first=Harvard Health|website=Harvard Health|access-date=2020-04-21|archive-date=2020-12-04|archive-url=https://web.archive.org/web/20201204090608/https://www.health.harvard.edu/pain/recovering_from_an_ankle_sprain|dead-url=no}}</ref>

=== 保守治疗 ===
根据受伤途径、关节症状<!--joint involvement-->和严重程度，大多数扭伤可在受伤后24小时内采取“{{le|RICE治疗法|RICE (medicine)}}”采取保守措施进行治疗。<ref>{{MedicalMnemonics|235|||}}</ref>然而，重要的是要认识到，治疗应根据患者的具体损伤和症状进行个体化。<ref>{{Cite journal|last=van den Bekerom|first=Michel P.J|last2=Struijs|first2=Peter A.A|last3=Blankevoort|first3=Leendert|last4=Welling|first4=Lieke|last5=van Dijk|first5=C. Niek|last6=Kerkhoffs|first6=Gino M.M.J|date=August 2012|title=What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?|url=https://archive.org/details/sim_journal-of-athletic-training_2012-08_47_4/page/435|journal=Journal of Athletic Training|volume=47|issue=4|pages=435–443|doi=10.4085/1062-6050-47.4.14|issn=1062-6050|pmc=3396304|pmid=22889660}}</ref>[[非甾体抗炎药]]（NSAID）等非处方药可以帮助缓解疼痛，外用非甾体抗炎药可以与口服药物一样有效。<ref>{{cite journal | vauthors = Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ | title = Topical NSAIDs for acute musculoskeletal pain in adults | journal = The Cochrane Database of Systematic Reviews | volume = 6 | issue = 6 | pages = CD007402 | date = June 2015 | pmid = 26068955 | doi = 10.1002/14651858.CD007402.pub3 | pmc = 6426435 }}</ref>

* 保护（Protect）： 应加以保护和固定受伤部位，因为韧带再次受伤的风险增加。<ref name=":1">{{cite journal | vauthors = Bleakley CM, O'Connor SR, Tully MA, Rocke LG, Macauley DC, Bradbury I, Keegan S, McDonough SM | title = Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial | journal = BMJ | volume = 340 | issue = may10 1 | pages = c1964 | date = May 2010 | pmid = 20457737 | doi = 10.1136/bmj.c1964 | doi-access = free }}</ref>
* 休息（Rest）：应固定受影响的关节，并尽量减少负重。例如，{{le|踝关节扭伤|sprained ankle|脚踝扭伤}}时应限制[[行走]].<ref name="AAOS">{{cite web |url=http://orthoinfo.aaos.org/topic.cfm?topic=A00150 |title=Sprained Ankle |access-date=2008-04-01 |date=March 2005 |publisher=American [[Orthopedic]] Foot and Ankle Society |archive-date=2017-11-15 |archive-url=https://web.archive.org/web/20171115082907/http://orthoinfo.aaos.org/topic.cfm?topic=A00150 |dead-url=no }}</ref>
*冰敷（Ice）：为了减少肿胀和疼痛，应立即在扭伤处敷冰块。<ref>{{Cite journal|last=Hubbard|first=Tricia J.|last2=Denegar|first2=Craig R.|date=2004|title=Does Cryotherapy Improve Outcomes With Soft Tissue Injury?|url=https://archive.org/details/sim_journal-of-athletic-training_2004-09_39_3/page/278|journal=Journal of Athletic Training|volume=39|issue=3|pages=278–279|issn=1062-6050|pmid=15496998|pmc=522152}}</ref>冰可以一天敷3-4次，每次10-15分钟，或直到肿胀消退，并且可以同时进行包扎。<ref name="AAOS" /> 冰也可以用于止痛，但为此目的只能在短时间内使用（少于20分钟）。<ref>{{cite journal | vauthors = Cramer H, Ostermann T, Dobos G | title = Injuries and other adverse events associated with yoga practice: A systematic review of epidemiological studies | journal = Journal of Science and Medicine in Sport | volume = 21 | issue = 2 | pages = 147–154 | date = February 2018 | pmid = 28958637 | doi = 10.1016/j.jsams.2017.08.026 }}</ref> 长时间暴露于冰中会减少流向受伤区域的血流量，减缓愈合过程。<ref>{{Cite journal|last=Singh|first=Daniel P.|last2=Barani Lonbani|first2=Zohreh|last3=Woodruff|first3=Maria A.|last4=Parker|first4=Tony J.|last5=Steck|first5=Roland|last6=Peake|first6=Jonathan M.|date=2017-03-07|title=Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and Myofiber Regeneration in Skeletal Muscle Following Contusion Injury|journal=Frontiers in Physiology|volume=8|pages=93|doi=10.3389/fphys.2017.00093|issn=1664-042X|pmc=5339266|pmid=28326040}}</ref>
* 加压（Compression）：应使用敷料、绷带固定扭伤部位并提供支持保护。包裹伤口时，应在伤口的末端施加更大的压力，并沿心脏方向减小压力。这有助于血液从四肢循环到心脏。通过{{le|冷压疗法|cold compression therapy}}仔细处理肿胀是愈合过程中的关键，它可以防止扭伤部位进一步积液。但是，加压不应妨碍肢体的循环。<ref name="AAOS" />
* 抬高（Elevation）：保持扭伤关节抬高（高于心脏），可以减少肿胀。<ref name="AAOS" />

其他非手术疗法如{{le|连续被动运动|Continuous passive motion}}（{{lang|en|continuous passive motion，CPM}}）在减轻肿胀和改善活动范围方面都是有效的。<ref>{{Cite journal|last=Liao|first=Chun-De|last2=Tsauo|first2=Jau-Yih|last3=Huang|first3=Shih-Wei|last4=Chen|first4=Hung-Chou|last5=Chiu|first5=Yen-Shuo|last6=Liou|first6=Tsan-Hon|date=April 2019|title=Preoperative range of motion and applications of continuous passive motion predict outcomes after knee arthroplasty in patients with arthritis|journal=Knee Surgery, Sports Traumatology, Arthroscopy|volume=27|issue=4|pages=1259–1269|doi=10.1007/s00167-018-5257-z|issn=1433-7347|pmid=30523369}}</ref>

=== 功能康复 ===
针对所有扭伤的有效康复计划的组成部分包括扩大受影响的关节的活动范围和逐步进行肌肉强化锻炼。<ref>{{Cite journal|last=Keene|first=David J|last2=Williams|first2=Mark A|last3=Segar|first3=Anand H|last4=Byrne|first4=Christopher|last5=Lamb|first5=Sarah E|date=2016-02-25|title=Immobilisation versus early ankle movement for treating acute lateral ankle ligament injuries in adults|journal=Cochrane Database of Systematic Reviews|doi=10.1002/14651858.cd012101|issn=1465-1858}}</ref> 在进行了减少肿胀和疼痛的保守治疗后，可在受伤后48-72小时内活动四肢，通过刺激肌肉骨骼组织中与[[细胞分裂]]和基质重塑相关的生长因子来促进愈合。<ref name=":6" />

长时间的固定会延迟扭伤的愈合，因为它通常会导致[[肌肉萎缩]]和无力。<ref>{{Cite journal|last=Mattacola|first=Carl G.|last2=Dwyer|first2=Maureen K.|date=2002|title=Rehabilitation of the Ankle After Acute Sprain or Chronic Instability|url=https://archive.org/details/sim_journal-of-athletic-training_2002-12_37_4/page/413|journal=Journal of Athletic Training|volume=37|issue=4|pages=413–429|issn=1062-6050|pmid=12937563|pmc=164373}}</ref>虽然长时间的固定会对恢复产生负面影响，但1996年的一项研究表明，使用支具或夹板可以固定骨头和受伤的韧带，从而提供保护，减轻疼痛并加快愈合速度。<ref name="familydoctor">[http://familydoctor.org/online/famdocen/home/healthy/physical/injuries/010.html Ankle Sprains: Healing and Preventing Injury] {{Wayback|url=http://familydoctor.org/online/famdocen/home/healthy/physical/injuries/010.html |date=20090624040500 }} Written by familydoctor.org editorial staff. American Academy of Family Physicians. Reviewed/Updated: 08/06. Created: 01/96</ref> 在使用支具时，必须确保有足够的足够的血液流向四肢。<ref name=":2">{{Citation|last=Hsu|first=Hunter|title=Forearm Splinting|date=2019|url=http://www.ncbi.nlm.nih.gov/books/NBK499980/|work=StatPearls|publisher=StatPearls Publishing|pmid=29763155|access-date=2019-03-12|last2=Siwiec|first2=Ryan M.|name-list-format=vanc}}</ref>最终，功能康复的目标是使患者恢复日常活动，同时将再次受伤的风险降至最低。