Qianru Li1, Yingchun Tu2, Jun Chen3, Jieling Shan4, Patrick Shu-Hang Yung5, Samuel Ka-Kin Ling5, Yinghui Hua6. 1. Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China. 2. Department of Orthopedics, Jinhua Municipal Central Hospital, Jinhua, Zhejiang, China. 3. Department of Orthopedics, Dongyang People's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. 4. Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China. 5. Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. 6. Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China. hua_cosm@aliyun.com.
Abstract
PURPOSE: To diagnose chronic anterior talofibular ligament (ATFL) injury, three different physical examinations were compared: the anterior drawer test (ADT), the anterolateral drawer test (ALDT), and the reverse anterolateral drawer test (RALDT). METHODS: A total of 72 ankles from potential ATFL-injured patients and the normal population were included and examined using the ADT, ALDT, and RALDT by two examiners without knowing the injury histories of any of the participants. Ultrasound examination was then applied as the gold standard to divide the ankles into the ATFL-injured group and the control group. The sensitivity (Se), specificity (Sp), false negative rate (FNR), false positive rate (FPR), accuracy, κ value, and p value of the two examiners' diagnoses were calculated to assess the diagnostic ability of each examination. RESULTS: There were 38 ankles in the injured group and 34 ankles in the control group. No significant difference was found between the two groups in terms of gender, age, body mass index (BMI), and included ankles. In the ADT and ALDT groups, the specificity reached one, while the sensitivity was relatively low (0.053 and 0.477 for the junior examiner and 0.395 and 0.500 for the senior examiner). In the RALDT, both the sensitivity and specificity were greater than 85% (0.868 and 0.912 for the senior examiner and 0.921 and 0.882 for the junior examiner). The κ value of the RALDT (0.639) was higher than that of the ALDT (0.528) and the ADT (0.196), whereas all the p values were less than 0.05. CONCLUSION: The ADT and ALDT are valuable physical tests to assess ATFL injuries. Compared with the traditional ADT and ALDT, however, the RALDT is more sensitive and accurate in diagnosing chronic ATFL injuries. LEVEL OF EVIDENCE: II (diagnostic).
PURPOSE: To diagnose chronic anterior talofibular ligament (ATFL) injury, three different physical examinations were compared: the anterior drawer test (ADT), the anterolateral drawer test (ALDT), and the reverse anterolateral drawer test (RALDT). METHODS: A total of 72 ankles from potential ATFL-injured patients and the normal population were included and examined using the ADT, ALDT, and RALDT by two examiners without knowing the injury histories of any of the participants. Ultrasound examination was then applied as the gold standard to divide the ankles into the ATFL-injured group and the control group. The sensitivity (Se), specificity (Sp), false negative rate (FNR), false positive rate (FPR), accuracy, κ value, and p value of the two examiners' diagnoses were calculated to assess the diagnostic ability of each examination. RESULTS: There were 38 ankles in the injured group and 34 ankles in the control group. No significant difference was found between the two groups in terms of gender, age, body mass index (BMI), and included ankles. In the ADT and ALDT groups, the specificity reached one, while the sensitivity was relatively low (0.053 and 0.477 for the junior examiner and 0.395 and 0.500 for the senior examiner). In the RALDT, both the sensitivity and specificity were greater than 85% (0.868 and 0.912 for the senior examiner and 0.921 and 0.882 for the junior examiner). The κ value of the RALDT (0.639) was higher than that of the ALDT (0.528) and the ADT (0.196), whereas all the p values were less than 0.05. CONCLUSION: The ADT and ALDT are valuable physical tests to assess ATFL injuries. Compared with the traditional ADT and ALDT, however, the RALDT is more sensitive and accurate in diagnosing chronic ATFL injuries. LEVEL OF EVIDENCE: II (diagnostic).
Authors: Kota Watanabe; Harold B Kitaoka; Lawrence J Berglund; Kristin D Zhao; Kenton R Kaufman; Kai-Nan An Journal: Clin Biomech (Bristol, Avon) Date: 2011-10-13 Impact factor: 2.063
Authors: Phillip A Gribble; Chris M Bleakley; Brian M Caulfield; Carrie L Docherty; François Fourchet; Daniel Tik-Pui Fong; Jay Hertel; Claire E Hiller; Thomas W Kaminski; Patrick O McKeon; Kathryn M Refshauge; Evert A Verhagen; Bill T Vicenzino; Erik A Wikstrom; Eamonn Delahunt Journal: Br J Sports Med Date: 2016-06-03 Impact factor: 13.800
Authors: Gwendolyn Vuurberg; Alexander Hoorntje; Lauren M Wink; Brent F W van der Doelen; Michel P van den Bekerom; Rienk Dekker; C Niek van Dijk; Rover Krips; Masja C M Loogman; Milan L Ridderikhof; Frank F Smithuis; Sjoerd A S Stufkens; Evert A L M Verhagen; Rob A de Bie; Gino M M J Kerkhoffs Journal: Br J Sports Med Date: 2018-03-07 Impact factor: 13.800
Authors: Claire E Hiller; Elizabeth J Nightingale; Jacqueline Raymond; Sharon L Kilbreath; Joshua Burns; Deborah A Black; Kathryn M Refshauge Journal: Arch Phys Med Rehabil Date: 2012-05-07 Impact factor: 3.966