Continuous femoral nerve block in patients undergoing total knee arthroplasty (TKA) improves and ... more Continuous femoral nerve block in patients undergoing total knee arthroplasty (TKA) improves and shortens postoperative rehabilitation. The primary aim of this study was to investigate whether the addition of sciatic nerve block to continuous femoral nerve block will shorten the time-to-discharge readiness. Ninety patients undergoing TKA were prospectively randomized to 1 of 3 groups: patient-controlled analgesia via femoral nerve catheter alone (F group) or combined with a single-injection (Fs group) or continuous sciatic nerve block (FCS group) until the second postoperative day. Discharge readiness was defined as the ability to walk and climb stairs independently, average pain on a numerical rating scale at rest lower than 4, and no complications. In addition, knee function, pain, supplemental morphine requirement, local anesthetic consumption, and postoperative nausea and vomiting (PONV) were evaluated. Median time-to-discharge readiness was similar: F group, 4 days (range, 2-16...
Background and purpose Review the literature concerning modalities to evaluate the integrity of t... more Background and purpose Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. Methods The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to identify all published original studies concerning diagnostic modalities to evaluate the integrity of the deltoid ligament in adult ankle fractures. Results This review included nine studies involving 423 ankle fractures. Three trails investigated medial tenderness; two studies, ecchymosis; two studies, swelling; one study, an injury radiograph; six studies, a type of radiographic stress view; one study, the Lauge-Hansen classiWcation; one study, MRI; and one article studied arthroscopy in the evaluation of the deltoid ligament integrity. Interpretation Swelling, ecchymosis, medial tenderness, initial injury radiographs and the Lauge-Hansen classiWcation are less adequate predictors of the integrity of the deltoid ligament. Manual or the less painful variant, the gravity external rotation stress radiographs are considered the gold standard. The amount of medial clear space widening indicative of a positive external rotation stress test has been somewhat variable in the literature but ¸5 mm is generally regarded as most reliable. Achieving adequate external rotation of the foot when obtaining stress radiographs is more important than positioning the ankle in the appropriate degree of ankle Xexion. The amount of applied force necessary when performing an external rotation stress radiograph is not well deWned and mainly determined by the patient's pain level. The indication for surgery should not be based on the absolute value of one parameter but on the combination of several parameters. If nonoperative treatment is chosen despite a positive stress radiograph, close follow-up is critical because subluxation of the ankle joint is still possible. MRI could be useful in individual cases.
Background: Acute lateral ankle ligament injuries are very common problems in present health care... more Background: Acute lateral ankle ligament injuries are very common problems in present health care. Still there is no hard evidence about which treatment strategy is superior. Current evidence supports the view that a functional treatment strategy is preferable, but insufficient data are present to prove the benefit of external support devices in these types of treatment. The hypothesis of our study is that external ankle support devices will not result in better outcome in the treatment of acute ankle sprains, compared to a purely functional treatment strategy. Overall objective is to compare the results of three different strategies of functional treatment for acute ankle sprain, especially to determine the advantages of external support devices in addition to functional treatment strategy, based on balance and coordination exercises. Methods/design: This study is designed as a randomised controlled multi-centre trial with one-year follow-up. Adult and healthy patients (N = 180) with acute, single sided and first inversion trauma of the lateral ankle ligaments will be included. They will all follow the same schedule of balancing exercises and will be divided into 3 treatment groups, 1. pressure bandage and tape, 2. pressure bandage and brace and 3. no external support. Primary outcome measure is the Karlsson scoring scale; secondary outcomes are FAOS (subscales), number of recurrent ankle injuries, Visual Analogue Scales of pain and satisfaction and adverse events. They will be measured after one week, 6 weeks, 6 months and 1 year.
Background: Anterior ankle arthroscopy is the preferred surgical approach for the treatment of os... more Background: Anterior ankle arthroscopy is the preferred surgical approach for the treatment of osteochondral defects of the talus (OCDs). However, the ankle is a congruent joint with limited surgical access. Purpose: The dual purpose of this study was (1) to quantify the anterior arthroscopic reach (defined as the proportion of the talar dome articular surface located anterior to the anterior distal tibial rim) with the ankle in full plantar flexion and (2) to identify predictive factors of the arthroscopic reach. Study Design: Descriptive laboratory study. Methods: Computed tomography scans were obtained of 59 ankles (57 patients aged 33 ± 11 years) in full plantar flexion in a nonmetallic 3-dimensional footplate. The arthroscopic reach of both the medial and lateral talar domes was assessed on sagittal reconstructions using a custom-made software routine. Intraobserver and interobserver reliability were calculated by intraclass correlation coefficients (ICCs). Various predictive f...
Ankle sprains are common problems in acute medical care. The variation in treatment observed for ... more Ankle sprains are common problems in acute medical care. The variation in treatment observed for the acutely injured lateral ankle ligament complex in the first week after the injury suggests a lack of evidence-based management strategies for this problem. To analyze the effectiveness of applying rest, ice, compression, and elevation (RICE) therapy begun within 72 hours after trauma for patients in the initial period after ankle sprain. Eligible studies were published original randomized or quasi-randomized controlled trials concerning at least 1 of the 4 subtreatments of RICE therapy in the treatment of acute ankle sprains in adults. MEDLINE, Cochrane Clinical Trial Register, CINAHL, and EMBASE. The lists of references of retrieved publications also were checked manually. We extracted relevant data on treatment outcome (pain, swelling, ankle mobility or range of motion, return to sports, return to work, complications, and patient satisfaction) and assessed the quality of included s...
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Abstract Osteochondral lesions of the talus are a relevant cause of pain and disability while the... more Abstract Osteochondral lesions of the talus are a relevant cause of pain and disability while their treatment remain challenging. If conservative treatments fail, surgical interventions such as core decompression, microfracturing of the talus or osteochondral treatments can be performed. As already described for the knee joint, there are also novel patient-specific implants for the treatment of focal osteochondral defects. For the first time such implant technology was used in the ankle joint. We report a 33-year-old male patient with persistent pain and reduced range of motion following an ankle sprain. He was referred after initial conservative treatment and an osteochondral autograft transplant. An MRI was performed to identify the location and dimension of the medial talar cystic defect with a length of 15 mm and a width of 7 mm. Using this data, a patient-specific implant and guiding instruments were manufactured for this surgery. Postoperatively, the patient reported reduced pain and improvements in clinical outcomes (range of motion) as well as in subjective scores Foot and Ankle Ability Measure (sports subscale), Foot Function Index, Visual Analogous Scale pain, Foot and Ankle Outcome Score and Healthy score were recorded preoperatively and at follow-ups up to 5 years. The patient returned to his former job as a car mechanic and plays soccer up to three times a week. In the presented case, the first implantation of a novel patient-specific metallic implant for the treatment of focal osteochondral lesion of the talus has been highly successful up to five years after implantation.
Introduction: The bipolar Judet radial head prosthesis can be used in unreconstructable, comminut... more Introduction: The bipolar Judet radial head prosthesis can be used in unreconstructable, comminuted radial head fractures and is available in two types: cemented and press-fit. The goal of this study was to describe the results of both implant types. Patients and methods: 33 patients with a Judet prosthesis (17 cemented, 16 press-fit) were retrospectively reviewed, with a median follow-up of 33 (range: 24-62) months. Results: Nineteen patients scored excellent, 10 scored good, 1 fair and 3 poor on the Mayo Elbow Performance Index, with a median of 100. The median Elbow Function Assessment score was 94. The median functional range of motion was 130° (range: 80°-145°). Median supination was 70° and median pronation also 70.0°. Complications occurred in 13 elbows. Eleven of the 16 elbows with a press-fit implant showed osteolysis proximal radius. In the cemented implant group periprosthetic lucencies were found in 2 of 19 patients. Discussion: The short-term functional results of the J...
The presence of anterior knee pain remains one of the major complaints following total knee arthr... more The presence of anterior knee pain remains one of the major complaints following total knee arthroplasty (TKA). Since the introduction of the mobile TKA, many studies have been performed and only a few show a slight advantage for the mobile. In our short-term follow-up study, we found less anterior knee pain in the posterior stabilized mobile knees compared to the posterior stabilized knees. The concept of self-alignment and the results from our short-term study led us to form the hypothesis that the posterior stabilized mobile knee leads to a lower incidence of anterior knee pain compared to the posterior stabilized fixed knee. This study was designed to see whether this difference remains after 7.9 years in the follow-up. A secondary line of enquiry was to see whether one was superior to the other regarding pain, function, quality of life and survival. This current report is a 6-10-year (median 7.9 years) follow-up study of the remaining 69 patients with a cemented three-component TKA for osteoarthritis in a prospective, randomized, double-blinded clinical trial. In the posterior stabilized group, five of the 40 knees (13%) versus five of the 29 posterior stabilized mobile group (17%) experienced anterior knee pain. No differences were observed with regard to ROM, VAS, Oxford 12-item knee questionnaire, SF-36, HSS patella, Kujala or the AKSS score. Patients with anterior knee pain reported more pain, lower levels of the AKSS, HSS patella and the Kujala scores than the patients without anterior knee pain. In the current clinical practice, the appearance of anterior knee pain persists as a problem; simply changing to a mobile bearing does not seem to be the solution. The posterior stabilized mobile total knee did not sustain the advantage of less anterior knee pain, compared with the posterior stabilized fixed total knee arthroplasty. Therapeutic study, Level II.
This is a follow-up to determine long-term outcomes after total knee arthroplasty (TKA) in patien... more This is a follow-up to determine long-term outcomes after total knee arthroplasty (TKA) in patients enrolled in a previous randomized trial that found reduced postoperative pain after addition of sciatic nerve block to continuous femoral nerve block for TKA. Physical function after TKA was evaluated at 3 and 12 months in patients (n = 89) receiving continuous femoral nerve block alone (group F), combined with a single-injection (group Fs) or continuous sciatic nerve block (group FCS) after TKA, until the second postoperative day. Physical function, stiffness, and pain were measured by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score 12-item knee questionnaires, and visual analog scale at rest and during mobilization before TKA and 3 and 12 months afterward. Post hoc, a median split on poor functioning (WOMAC) was analyzed. Western Ontario and McMaster Universities Osteoarthritis Index, Oxford Knee Score 12-item knee, and visual analog s...
TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde, 2012
ABSTRACT In Nederland krijgen ongeveer 600.000 personen jaarlijks een traumatisch letsel van de e... more ABSTRACT In Nederland krijgen ongeveer 600.000 personen jaarlijks een traumatisch letsel van de enkel van wie ongeveer een derde als gevolg van sportbeoefening. Ongeveer een derde van de totale economische kosten als gevolg van sportletsel wordt veroorzaakt door enkelletsel. De preventie van herhaling van deze letsels kan resulteren in een forse besparing op medische kosten. Het gemiddelde werkverzuim bij patiënten met een functioneel behandeld lateraal enkelbandletsel is 2,5 week; na 6 weken heeft 90% het werk hervat. Van de patiënten die het sporten hervat, heeft 60-90% binnen 12 weken de sportbeoefening op hetzelfde niveau als voor het trauma. De aanbevelingen in deze richtlijn zijn gebaseerd op wetenschappelijk bewijs en bedoeld voor alle zorgverleners die betrokken zijn bij de behandeling en begeleiding van patiënten met lateraal bandletsel van de enkel.
Continuous femoral nerve block in patients undergoing total knee arthroplasty (TKA) improves and ... more Continuous femoral nerve block in patients undergoing total knee arthroplasty (TKA) improves and shortens postoperative rehabilitation. The primary aim of this study was to investigate whether the addition of sciatic nerve block to continuous femoral nerve block will shorten the time-to-discharge readiness. Ninety patients undergoing TKA were prospectively randomized to 1 of 3 groups: patient-controlled analgesia via femoral nerve catheter alone (F group) or combined with a single-injection (Fs group) or continuous sciatic nerve block (FCS group) until the second postoperative day. Discharge readiness was defined as the ability to walk and climb stairs independently, average pain on a numerical rating scale at rest lower than 4, and no complications. In addition, knee function, pain, supplemental morphine requirement, local anesthetic consumption, and postoperative nausea and vomiting (PONV) were evaluated. Median time-to-discharge readiness was similar: F group, 4 days (range, 2-16...
Background and purpose Review the literature concerning modalities to evaluate the integrity of t... more Background and purpose Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. Methods The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to identify all published original studies concerning diagnostic modalities to evaluate the integrity of the deltoid ligament in adult ankle fractures. Results This review included nine studies involving 423 ankle fractures. Three trails investigated medial tenderness; two studies, ecchymosis; two studies, swelling; one study, an injury radiograph; six studies, a type of radiographic stress view; one study, the Lauge-Hansen classiWcation; one study, MRI; and one article studied arthroscopy in the evaluation of the deltoid ligament integrity. Interpretation Swelling, ecchymosis, medial tenderness, initial injury radiographs and the Lauge-Hansen classiWcation are less adequate predictors of the integrity of the deltoid ligament. Manual or the less painful variant, the gravity external rotation stress radiographs are considered the gold standard. The amount of medial clear space widening indicative of a positive external rotation stress test has been somewhat variable in the literature but ¸5 mm is generally regarded as most reliable. Achieving adequate external rotation of the foot when obtaining stress radiographs is more important than positioning the ankle in the appropriate degree of ankle Xexion. The amount of applied force necessary when performing an external rotation stress radiograph is not well deWned and mainly determined by the patient's pain level. The indication for surgery should not be based on the absolute value of one parameter but on the combination of several parameters. If nonoperative treatment is chosen despite a positive stress radiograph, close follow-up is critical because subluxation of the ankle joint is still possible. MRI could be useful in individual cases.
Background: Acute lateral ankle ligament injuries are very common problems in present health care... more Background: Acute lateral ankle ligament injuries are very common problems in present health care. Still there is no hard evidence about which treatment strategy is superior. Current evidence supports the view that a functional treatment strategy is preferable, but insufficient data are present to prove the benefit of external support devices in these types of treatment. The hypothesis of our study is that external ankle support devices will not result in better outcome in the treatment of acute ankle sprains, compared to a purely functional treatment strategy. Overall objective is to compare the results of three different strategies of functional treatment for acute ankle sprain, especially to determine the advantages of external support devices in addition to functional treatment strategy, based on balance and coordination exercises. Methods/design: This study is designed as a randomised controlled multi-centre trial with one-year follow-up. Adult and healthy patients (N = 180) with acute, single sided and first inversion trauma of the lateral ankle ligaments will be included. They will all follow the same schedule of balancing exercises and will be divided into 3 treatment groups, 1. pressure bandage and tape, 2. pressure bandage and brace and 3. no external support. Primary outcome measure is the Karlsson scoring scale; secondary outcomes are FAOS (subscales), number of recurrent ankle injuries, Visual Analogue Scales of pain and satisfaction and adverse events. They will be measured after one week, 6 weeks, 6 months and 1 year.
Background: Anterior ankle arthroscopy is the preferred surgical approach for the treatment of os... more Background: Anterior ankle arthroscopy is the preferred surgical approach for the treatment of osteochondral defects of the talus (OCDs). However, the ankle is a congruent joint with limited surgical access. Purpose: The dual purpose of this study was (1) to quantify the anterior arthroscopic reach (defined as the proportion of the talar dome articular surface located anterior to the anterior distal tibial rim) with the ankle in full plantar flexion and (2) to identify predictive factors of the arthroscopic reach. Study Design: Descriptive laboratory study. Methods: Computed tomography scans were obtained of 59 ankles (57 patients aged 33 ± 11 years) in full plantar flexion in a nonmetallic 3-dimensional footplate. The arthroscopic reach of both the medial and lateral talar domes was assessed on sagittal reconstructions using a custom-made software routine. Intraobserver and interobserver reliability were calculated by intraclass correlation coefficients (ICCs). Various predictive f...
Ankle sprains are common problems in acute medical care. The variation in treatment observed for ... more Ankle sprains are common problems in acute medical care. The variation in treatment observed for the acutely injured lateral ankle ligament complex in the first week after the injury suggests a lack of evidence-based management strategies for this problem. To analyze the effectiveness of applying rest, ice, compression, and elevation (RICE) therapy begun within 72 hours after trauma for patients in the initial period after ankle sprain. Eligible studies were published original randomized or quasi-randomized controlled trials concerning at least 1 of the 4 subtreatments of RICE therapy in the treatment of acute ankle sprains in adults. MEDLINE, Cochrane Clinical Trial Register, CINAHL, and EMBASE. The lists of references of retrieved publications also were checked manually. We extracted relevant data on treatment outcome (pain, swelling, ankle mobility or range of motion, return to sports, return to work, complications, and patient satisfaction) and assessed the quality of included s...
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Abstract Osteochondral lesions of the talus are a relevant cause of pain and disability while the... more Abstract Osteochondral lesions of the talus are a relevant cause of pain and disability while their treatment remain challenging. If conservative treatments fail, surgical interventions such as core decompression, microfracturing of the talus or osteochondral treatments can be performed. As already described for the knee joint, there are also novel patient-specific implants for the treatment of focal osteochondral defects. For the first time such implant technology was used in the ankle joint. We report a 33-year-old male patient with persistent pain and reduced range of motion following an ankle sprain. He was referred after initial conservative treatment and an osteochondral autograft transplant. An MRI was performed to identify the location and dimension of the medial talar cystic defect with a length of 15 mm and a width of 7 mm. Using this data, a patient-specific implant and guiding instruments were manufactured for this surgery. Postoperatively, the patient reported reduced pain and improvements in clinical outcomes (range of motion) as well as in subjective scores Foot and Ankle Ability Measure (sports subscale), Foot Function Index, Visual Analogous Scale pain, Foot and Ankle Outcome Score and Healthy score were recorded preoperatively and at follow-ups up to 5 years. The patient returned to his former job as a car mechanic and plays soccer up to three times a week. In the presented case, the first implantation of a novel patient-specific metallic implant for the treatment of focal osteochondral lesion of the talus has been highly successful up to five years after implantation.
Introduction: The bipolar Judet radial head prosthesis can be used in unreconstructable, comminut... more Introduction: The bipolar Judet radial head prosthesis can be used in unreconstructable, comminuted radial head fractures and is available in two types: cemented and press-fit. The goal of this study was to describe the results of both implant types. Patients and methods: 33 patients with a Judet prosthesis (17 cemented, 16 press-fit) were retrospectively reviewed, with a median follow-up of 33 (range: 24-62) months. Results: Nineteen patients scored excellent, 10 scored good, 1 fair and 3 poor on the Mayo Elbow Performance Index, with a median of 100. The median Elbow Function Assessment score was 94. The median functional range of motion was 130° (range: 80°-145°). Median supination was 70° and median pronation also 70.0°. Complications occurred in 13 elbows. Eleven of the 16 elbows with a press-fit implant showed osteolysis proximal radius. In the cemented implant group periprosthetic lucencies were found in 2 of 19 patients. Discussion: The short-term functional results of the J...
The presence of anterior knee pain remains one of the major complaints following total knee arthr... more The presence of anterior knee pain remains one of the major complaints following total knee arthroplasty (TKA). Since the introduction of the mobile TKA, many studies have been performed and only a few show a slight advantage for the mobile. In our short-term follow-up study, we found less anterior knee pain in the posterior stabilized mobile knees compared to the posterior stabilized knees. The concept of self-alignment and the results from our short-term study led us to form the hypothesis that the posterior stabilized mobile knee leads to a lower incidence of anterior knee pain compared to the posterior stabilized fixed knee. This study was designed to see whether this difference remains after 7.9 years in the follow-up. A secondary line of enquiry was to see whether one was superior to the other regarding pain, function, quality of life and survival. This current report is a 6-10-year (median 7.9 years) follow-up study of the remaining 69 patients with a cemented three-component TKA for osteoarthritis in a prospective, randomized, double-blinded clinical trial. In the posterior stabilized group, five of the 40 knees (13%) versus five of the 29 posterior stabilized mobile group (17%) experienced anterior knee pain. No differences were observed with regard to ROM, VAS, Oxford 12-item knee questionnaire, SF-36, HSS patella, Kujala or the AKSS score. Patients with anterior knee pain reported more pain, lower levels of the AKSS, HSS patella and the Kujala scores than the patients without anterior knee pain. In the current clinical practice, the appearance of anterior knee pain persists as a problem; simply changing to a mobile bearing does not seem to be the solution. The posterior stabilized mobile total knee did not sustain the advantage of less anterior knee pain, compared with the posterior stabilized fixed total knee arthroplasty. Therapeutic study, Level II.
This is a follow-up to determine long-term outcomes after total knee arthroplasty (TKA) in patien... more This is a follow-up to determine long-term outcomes after total knee arthroplasty (TKA) in patients enrolled in a previous randomized trial that found reduced postoperative pain after addition of sciatic nerve block to continuous femoral nerve block for TKA. Physical function after TKA was evaluated at 3 and 12 months in patients (n = 89) receiving continuous femoral nerve block alone (group F), combined with a single-injection (group Fs) or continuous sciatic nerve block (group FCS) after TKA, until the second postoperative day. Physical function, stiffness, and pain were measured by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score 12-item knee questionnaires, and visual analog scale at rest and during mobilization before TKA and 3 and 12 months afterward. Post hoc, a median split on poor functioning (WOMAC) was analyzed. Western Ontario and McMaster Universities Osteoarthritis Index, Oxford Knee Score 12-item knee, and visual analog s...
TBV – Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde, 2012
ABSTRACT In Nederland krijgen ongeveer 600.000 personen jaarlijks een traumatisch letsel van de e... more ABSTRACT In Nederland krijgen ongeveer 600.000 personen jaarlijks een traumatisch letsel van de enkel van wie ongeveer een derde als gevolg van sportbeoefening. Ongeveer een derde van de totale economische kosten als gevolg van sportletsel wordt veroorzaakt door enkelletsel. De preventie van herhaling van deze letsels kan resulteren in een forse besparing op medische kosten. Het gemiddelde werkverzuim bij patiënten met een functioneel behandeld lateraal enkelbandletsel is 2,5 week; na 6 weken heeft 90% het werk hervat. Van de patiënten die het sporten hervat, heeft 60-90% binnen 12 weken de sportbeoefening op hetzelfde niveau als voor het trauma. De aanbevelingen in deze richtlijn zijn gebaseerd op wetenschappelijk bewijs en bedoeld voor alle zorgverleners die betrokken zijn bij de behandeling en begeleiding van patiënten met lateraal bandletsel van de enkel.
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