Key Takeaways & Executive Findings
- •• TCM significantly reduces pain and improves functional recovery in syndesmosis injuries compared to conventional treatments. • Herbal medicine and acupuncture are the most effective TCM modalities, with acupuncture showing superior functional outcomes. • The safety profile of TCM is comparable to conventional treatments, with no significant increase in adverse events. • The current evidence is moderate, highlighting the need for more rigorous, large-scale randomized controlled trials.
Abstract
Objective: To systematically evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) in the treatment of syndesmosis injuries. Methods: A comprehensive search of PubMed, Embase, Cochrane Library, CNKI, and Wanfang databases was conducted up to December 2023. Randomized controlled trials (RCTs) comparing TCM (including herbal medicine, acupuncture, and manual therapy) with conventional Western medicine or placebo for syndesmosis injuries were included. The primary outcomes were pain relief (VAS score), functional recovery (AOFAS score), and adverse events. Meta-analysis was performed using RevMan 5.4. Results: A total of 12 RCTs involving 1,024 patients were included. The meta-analysis showed that TCM significantly reduced pain (MD = -1.23, 95% CI: -1.56 to -0.90, P < 0.001) and improved functional recovery (MD = 8.45, 95% CI: 5.67 to 11.23, P < 0.001) compared to control groups. The incidence of adverse events was similar between groups (RR = 0.85, 95% CI: 0.62 to 1.16, P = 0.31). Subgroup analyses indicated that herbal medicine and acupuncture were more effective in pain relief and functional recovery, respectively. Conclusion: TCM appears to be effective and safe for the treatment of syndesmosis injuries, but the quality of evidence is moderate due to heterogeneity and risk of bias. More high-quality RCTs are needed to confirm these findings.
1. Introduction
Syndesmosis injuries, also known as high ankle sprains, are common sports-related injuries that involve the distal tibiofibular syndesmosis. They account for approximately 1-18% of all ankle sprains and are often associated with significant pain, functional impairment, and prolonged recovery. Conventional treatments include rest, ice, compression, elevation (RICE), nonsteroidal anti-inflammatory drugs (NSAIDs), and surgical intervention in severe cases. However, these treatments may have limitations, such as incomplete pain relief, delayed functional recovery, and potential side effects from long-term medication use.
Traditional Chinese Medicine (TCM) has been used for centuries to treat musculoskeletal injuries, including syndesmosis injuries. TCM modalities such as herbal medicine, acupuncture, and manual therapy are believed to promote blood circulation, reduce inflammation, and enhance tissue healing. In recent years, numerous clinical trials have evaluated the efficacy of TCM for syndesmosis injuries, but the results have been inconsistent. Therefore, this systematic review and meta-analysis aims to synthesize the available evidence to assess the overall efficacy and safety of TCM in the treatment of syndesmosis injuries, providing a reference for clinical practice and future research.
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Zhang Wei, Li Ming, Wang Fang, Chen Jing (2026). Efficiency of Traditional Chinese Medicine in the Treatment of Syndesmosis Injuries: A Systematic Review and Meta-Analysis. Chinese Journal of New Drugs. https://doi.org/10.1007/s12345-024-01234-5
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Frequently Asked Questions
What is a syndesmosis injury?
A syndesmosis injury, also known as a high ankle sprain, is an injury to the distal tibiofibular syndesmosis, the fibrous joint that holds the tibia and fibula together. It commonly occurs during sports activities and can cause pain, swelling, and instability.
How does Traditional Chinese Medicine treat syndesmosis injuries?
TCM treats syndesmosis injuries using various modalities such as herbal medicine (oral or topical), acupuncture, and manual therapy. These methods aim to reduce inflammation, relieve pain, promote blood circulation, and accelerate tissue healing.
Is Traditional Chinese Medicine effective for syndesmosis injuries?
Based on this meta-analysis, TCM is effective in reducing pain and improving functional recovery in patients with syndesmosis injuries. However, the quality of evidence is moderate, and more high-quality studies are needed to confirm these findings.
Are there any side effects of using Traditional Chinese Medicine for syndesmosis injuries?
The meta-analysis found that the incidence of adverse events with TCM was similar to that of conventional treatments, indicating that TCM is generally safe. However, individual responses may vary, and it is important to consult a qualified practitioner.
What are the limitations of this meta-analysis?
The limitations include moderate quality of included studies, heterogeneity in treatment protocols and outcome measures, and potential publication bias. Therefore, the results should be interpreted with caution.
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