Biomechanical analysis of the ankle anterior drawer test for anterior talofibular ligament injuries

1995 ◽  
Vol 13 (4) ◽  
pp. 609-614 ◽  
Author(s):  
Harukazu Tohyama ◽  
Bruce D. Beynnon ◽  
Per A. Renström ◽  
Maureen J. Theis ◽  
Braden C. Fleming ◽  
...  
Keyword(s):  
Biomechanical Analysis ◽  
Anterior Talofibular Ligament ◽  
Ligament Injuries ◽  
Anterior Drawer ◽  
Anterior Drawer Test

Radiological Assessment of a Modified Anterior Drawer Test of the Ankle

Foot & Ankle ◽  
1992 ◽  
Vol 13 (7) ◽  
pp. 400-403 ◽  
Author(s):  
M. Nyska ◽  
H. Amir ◽  
A. Porath ◽  
S. Dekel
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Anterior Talofibular Ligament ◽  
Common Complication ◽  
Anterior Drawer ◽  
Lateral Tilt ◽  
Anterior Drawer Test ◽  
Significant Movement ◽  
Recurrent Ankle Sprain ◽  
Radiological Examinations

Chronic ankle instability is a common complication of ankle sprain. The clinical assessment of ankle instability is usually incomplete and difficult to interpret. Recently, more attention has been paid to the value of the anterior drawer test of the ankle. We assessed the accuracy of a modification of the anterior drawer test, comparing it with radiological stress view of the ankle in 25 patients with recurrent ankle sprain. The radiological examinations were performed by a TELOS instrument and included lateral and anteroposterior stress views. We found that the modified anterior drawer test correlated with the posterior opening of the tibiotalar joint and with the lateral tilt of the talus. We conclude that a slightly positive modified anterior drawer test may indicate injury to the anterior talofibular ligament. A significant movement of the ankle elicited by the modified anterior drawer test may indicate combined injury to anterior talofibular and calcaneofibular ligaments.

Anterior Drawer Test for Acute Anterior Talofibular Ligament Injuries of the Ankle: How Much Load Should be Applied during the Test?

2003 ◽  
Vol 31 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Harukazu Tohyama ◽  
Kazunori Yasuda ◽  
Yasumitu Ohkoshi ◽  
Bruce D. Beynnon ◽  
Per A. Renstrom
Keyword(s):  
Cadaver Study ◽  
Ankle Injuries ◽  
Ligament Injury ◽  
Normal Displacement ◽  
Anterior Talofibular Ligament ◽  
Anterior Drawer ◽  
Anterior Drawer Test ◽  
Ankle Ligament ◽  
Anterior Posterior

Background: There is a lack of consensus regarding the magnitude of load for performing the anterior drawer test in evaluating acute ankle injuries. Purpose: To determine how much load should be applied during the anterior drawer test to detect the integrity of the anterior talofibular ligament. Methods: First, the anterior-posterior load-displacement response of nine cadaveric ankles was measured. Second, anterior displacement of the ankle was measured at 30 and 60 N of anterior load in 14 patients with acute tears of the anterior talofibular ligament. Results: In the cadaver study, the increased displacement by sectioning of the ligament measured at 10, 20, 30, and 40 N of anterior load were significantly greater than those measured at 60 N. In vivo examination of the subjects without anesthesia demonstrated that the injured-to-normal displacement value at 30 N of anterior load was significantly greater than the value at 60 N. Conclusions: This study suggests that a large magnitude of anterior load is not necessary to detect the integrity of the ligament during the anterior drawer test. Clinical Relevance: When evaluating the integrity of the anterior talofibular ligament in cases of acute ankle ligament injury, a relatively low-magnitude load should be applied.

Quantitative Evaluation of Ankle Instability Using a Capacitance-Type Strain Sensor

2021 ◽  
pp. 107110072199671
Author(s):  
Atsushi Teramoto ◽  
Kousuke Iba ◽  
Yasutaka Murahashi ◽  
Hiroaki Shoji ◽  
Kento Hirota ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Anterior Talofibular Ligament ◽  
Calcaneofibular Ligament ◽  
Radiographic Images ◽  
Anterior Drawer ◽  
Anterior Drawer Test ◽  
History Of ◽  
The Mean

Background: Manual evaluation is an important method for assessing ankle instability, but it is not quantitative. Capacitance-type sensors can be used to measure the distance on the basis of the capacitance value. We applied the sensor to the noninvasive device for measuring ankle instability and showed its utility. Methods: First, 5 ankles embalmed by Thiel’s method were used in an experiment using a cadaver. The capacitance-type sensor was fixed alongside the anterior talofibular ligament (ATFL) of a specially made brace, and the anterior drawer test was performed. The test had been performed for the intact ankle, with the ATFL transected and with both the ATFL and calcaneofibular ligament (CFL) transected. The anterior drawer distance was calculated by the sensor. Intra- and interinvestigator reliability were also analyzed. Next, as a clinical study, a brace with a sensor was fitted to 22 ankles of 20 patients with a history of ankle sprain. An anterior drawer test at a load of 150 N was conducted using a Telos stress device. The anterior drawer distances measured by the sensor and based on radiographic images were then compared. Results: The mean anterior drawer distances were 3.7 ± 1.0 mm for the intact cadavers, 6.1 ± 1.6 mm with the ATFL transected ( P < .001), and 7.9 ± 1.8 mm with the ATFL and CFL transected ( P < .001). The intrainvestigator intraclass correlation coefficients (ICCs) were 0.862 to 0.939, and the interinvestigator ICC was 0.815. In the experiments on patients, the mean anterior drawer distance measured by the sensor was 2.9 ± 0.9 mm, and it was 2.7 ± 0.9 mm for the radiographic images. The correlation coefficient between the sensor and the radiographic images was 0.843. Conclusion: We quantitatively evaluated anterior drawer laxity using a capacitance-type sensor and found it had high reproducibility and strongly correlated with stress radiography measurements in patients with ankle instability. Capacitance-type sensors can be used for the safe, simple, and accurate evaluation of ankle instability.

scholarly journals A preliminary study exploring the change in ankle joint laxity and general joint laxity during the menstrual cycle in cis women

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Tomomi Yamazaki ◽  
Sae Maruyama ◽  
Yuki Sato ◽  
Yukako Suzuki ◽  
Sohei Shimizu ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Ankle Joint ◽  
Length Change ◽  
Joint Laxity ◽  
Anterior Talofibular Ligament ◽  
Menstrual Phase ◽  
Anterior Drawer ◽  
Linear Distance ◽  
Significant Difference ◽  
Early Follicular Phase

Abstract Background The purpose of the present study was to examine the relationship between ankle joint laxity and general joint laxity (GJL) in relation to the menstrual cycle, which was divided into four phases based on basal body temperature and ovulation, assessed using an ovulation kit. Methods Participants were 14 female college students (21–22 years) with normal menstrual cycles (cis gender). Anterior drawer stress to a magnitude of 120 N was applied for all participants. Anterior talofibular ligament (ATFL) length was measured as the linear distance (mm) between its points of attachment on the lateral malleolus and talus using ultrasonography. Data on ATFL length from each subject were used to calculate each subject’s normalized length change with anterior drawer stress (AD%). The University of Tokyo method was used for evaluation of GJL. AD% and GJL were measured once in each menstrual phase. Results There was no statistically significant difference between AD% in each phase. GJL score was significantly higher in the ovulation and luteal phases compared with the early follicular phase. AD% and GJL showed a positive correlation with each other in the ovulation phase. Conclusions Although it is unclear whether estrogen receptors are present in the ATFL, the present study suggests that women with high GJL scores might be more sensitive to the effects of estrogen, resulting in ATFL length change in the ovulation phase.

scholarly journals Patient self-demonstration of the anterior drawer test in an ACL deficient knee

2015 ◽  
Vol 2015 (jan23 2) ◽  
pp. bcr2014207516-bcr2014207516
Author(s):  
P. Ellanti ◽  
K. J. Mulhall
Keyword(s):  
Anterior Drawer ◽  
Anterior Drawer Test ◽  
Acl Deficient ◽  
Deficient Knee

A Better Anterior Drawer Test

2005 ◽  
Vol 33 (4) ◽  
pp. 7-7
Author(s):  
Robert E. Sallis ◽  
Sean T. Mullendore ◽  
Barry P. Boden
Keyword(s):  
Anterior Drawer ◽  
Anterior Drawer Test

scholarly journals Diagnosing the Impact of the Syndesmotic Injury on Lateral Ankle Stability using Dynamic Ultrasound

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0013
Author(s):  
Rohan Bhimani ◽  
Jirawat Saengsin ◽  
Go Sato ◽  
Noortje Hagemeijer ◽  
Bart Lubberts ◽  
...  
Keyword(s):  
Anterior Talofibular Ligament ◽  
Syndesmotic Injury ◽  
Lateral Ankle ◽  
Anterior Drawer ◽  
Intact State ◽  
Tibiofibular Ligament ◽  
Ankle Stability ◽  
Clear Space ◽  
Lateral Ankle Ligament ◽  
The Impact

Category: Ankle; Basic Sciences/Biologics; Sports; Trauma Introduction/Purpose: There is a high prevalence of coexisting lateral ankle ligament injuries and syndesmotic ligamentous injuries. However, it is unclear whether syndesmotic ligaments directly contribute toward the stability of the lateral ankle. Dynamic ultrasonography (US) is an imaging modality increasingly used for the care of orthopaedic foot and ankle patients because it allows dynamic evaluation of structures at the point of care with little risk to the patient and at low-cost. The aim of this study is to assess the effect of syndesmotic injury as well as combined syndesmotic and lateral ankle injury on the stability of the lateral ankle. Methods: Sixteen fresh frozen above-knee amputated cadaveric specimens, divided into two groups, underwent ultrasound evaluation for lateral ankle stability. In both the groups, the assessment was first done with all ligaments intact and later with sequential transection of anterior inferior tibiofibular ligament (AITFL), interosseous ligament (IOL), posterior inferior tibiofibular ligament (PITFL), anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL) and posterior talofibular ligament (PTFL). In all scenarios, two loading conditions were considered: (1) Anterior drawer test: 50N and 80N and (2) Lateral clear space (LCS): 1.7Nm torque. The talar translation and LCS to the fixed tibial plafond were measured using Image J. Wilcoxon rank-sum test was used to compare the findings of each ligamentous transection state to the intact state. A p-value <0.05 was considered statistically significant. Results: In group 1 after transection of the all syndesmotic ligament and ATFL, an increase in the anterior drawer and lateral clear space values were found as compared to the intact state. Similarly, in group 2 the anterior drawer and lateral clear space values significantly increased after transection of the AITFL and ATFL as compared to the intact state (p-values = 0.01). Conclusion: Ultrasound can be used to evaluate the impact of the syndesmotic injury on lateral ankle stability while performing dynamic stress maneuvers. Lateral ankle instability appears after injury to all syndesmotic ligaments and ATFL, or after one syndesmotic ligament rupture (AITFL) with a concomitant anterior talofibular ligament rupture (ATFL). These findings suggest that surgeons should lower their threshold for stabilizing the syndesmosis if there is a concomitant lateral ankle ligament injury. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document