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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-04-2016 | Ankle

Diagnostic validity of alternative manual stress radiographic technique detecting subtalar instability with concomitant ankle instability

Authors: Byung Hoon Lee, Kyung-Hwa Choi, Dong Yeon Seo, Sang Min Choi, Gab Lae Kim

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2016

Abstract

Purpose

To incorporate a diagnostic technique for measuring subtalar motion, namely “talar rotation”, into the manual supination-anterior drawer stress radiographs for evaluation of the severity of rotational instability, and to determine its clinical relevance.

Methods

Sixty-six patients with combined injuries of the anterior talofibular (ATFL) and calcaneofibular ligament (CFL) underwent three bilateral manual stress radiographs, and mean increments of anterior talar translation (mm), talar tilt (°), and talar rotation (%) in the injured ankle compared to the normal opposite side were measured with the technique. Intraobserver and interobserver reliability of each measure was assessed, and the difference in the degree of increments was compared according to the presence of additional cervical ligament insufficiency.

Results

Ankle stress radiographic intraobserver and interobserver agreement was ICC = 0.91 and 0.82 for talar rotation (%), ICC = 0.64 and 0.51 for anterior talar translation, and ICC = 0.78 and 0.71 for talar tilt angle, respectively. In group 2 including patients with combined injuries of the ATFL and CFL along with additional cervical ligament insufficiency, a significantly higher increment of talar rotation, mean 6.4 % (SD 3.4 %), was observed compared to that of talar rotation, mean 4.1 % (SD 2.7 %), in the other group (group 1) with an intact cervical ligament (p < 0.001).

Conclusions

A new comprehensive stress radiographic technique for diagnosis of chronic lateral ankle instability presented in this study might be a reliable and representable measurement tool to assess additional injury or instability of the subtalar joint.

Level of evidence

Prospective cohort study, Level II.

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Title: Diagnostic validity of alternative manual stress radiographic technique detecting subtalar instability with concomitant ankle instability
Authors: Byung Hoon Lee
Kyung-Hwa Choi
Dong Yeon Seo
Sang Min Choi
Gab Lae Kim
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-016-4037-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diagnostic validity of alternative manual stress radiographic technique detecting subtalar instability with concomitant ankle instability

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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