Anterolateral Drawer Versus Anterior Drawer Test for Ankle Instability

2015 ◽  
Vol 37 (4) ◽  
pp. 407-410 ◽  
Author(s):  
Adam G. Miller ◽  
Stuart H. Myers ◽  
Brent G. Parks ◽  
Gregory P. Guyton
Keyword(s):  
Ankle Instability ◽  
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.

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 Clinical outcomes of anterior tibiofibular ligament’s distal fascicle transfer versus ligament reconstruction with InternalBrace™ for chronic ankle instability patients

2021 ◽  
Author(s):  
Jiaxin Tian ◽  
Tsz-Ngai Mok ◽  
Tat-Hang Sin ◽  
Zhengang Zha ◽  
Xiaofei Zheng ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Clinical Effectiveness ◽  
Chronic Ankle Instability ◽  
Anterior Drawer ◽  
Anterior Drawer Test ◽  
Tibiofibular Ligament ◽  
Transfer Group

Abstract Purpose Treatment of chronic ankle instability (CAI) for ankle sprain patients remains a challenge. If initial treatments fail, surgical stabilization techniques including ligament reconstruction should be performed. Anterior tibiofibular ligament (ATiFL) distal fascicle transfer for CAI was recently introduced. The goal of the study is to assess the 1-year clinical effectiveness of ATiFL’s distal fascicle transfer versus ligament reconstruction with InternalBrace™ (Fa. Arthrex, Naples). Methods Between October 2019 and February 2021, 25 patients (14 males and 11 females) scheduled for ligament reconstruction treatment of CAI were enrolled after propensity score matching. Twelve underwent ligament reconstruction with InternalBrace™ (InternalBrace™ group) and thirteen underwent ATiFL’s distal fascicle transfer (ATiFL’s distal fascicle transfer group). We recorded the American Orthopedic Foot & Ankle Society (AOFAS) score, Visual Analogue Scale (VAS), anterior drawer test grade, patient satisfaction and complications. All results of this study were retrospectively analyzed. Results Statistically significant (p = 0.0251, independent-samples t test) differences in the AOFAS can be found between the ATiFL’s distal fascicle transfer group and the InternalBrace™ group. No substantial changes in the VAS (p = 0.1778, independent-samples t test), patient satisfaction (p = 0.1800, independent-samples t test) and anterior drawer test grade (p = 0.9600, independent-samples t test) were found between the two groups. There was one patient with superficial wound infection and one patient with sural nerve injury in the InternalBrace™ group and ATiFL’s distal fascicle transfer group, respectively. Conclusion This is the first study that assessed a cohort of CAI patients and suggests that the ATiFL’s distal fascicle transfer operation has the potential to attain good-to-excellent clinical outcomes after 1-year recovery. The AOFAS scores were significantly higher for patients with ATiFL’s distal fascicle transfer, indicating that this technique may be considered a viable option for both patients and their surgeon, while long-term outcomes should be investigated in the future.

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

scholarly journals A Retrospective Chart Review to Examine Failed Modified Brostrom Procedures for Chronic Lateral Ankle Instability

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0040
Author(s):  
Kaitlyn Rizzo ◽  
Greggory Brandle ◽  
Nicholas A. Cheney ◽  
Brian C. Clark
Keyword(s):  
Chart Review ◽  
Ankle Instability ◽  
Retrospective Chart Review ◽  
Tilt Test ◽  
Recurrent Instability ◽  
Lateral Ankle ◽  
Anterior Drawer ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Modified Broström Procedure

Category: Ankle; Other Introduction/Purpose: Recurrent ankle injuries can lead to chronic ankle instability requiring surgical stabilization. Since the anterior talofibular ligament (ATFL) is the weakest of the lateral ankle ligaments, repair is often required in cases of chronic lateral ankle instability. Damage to the calcaneofibular ligament (CFL) is less common than the ATFL, but additional repair of it in these cases may be necessary to avoid this recurrent instability. A modified Brostrom procedure has been a widely accepted surgical approach to chronic lateral ankle instability if conservative measures fail. However, cases of recurrent instability even after initial stabilization surgery can present. The purpose was to examine reasoning for and rate of revision surgeries attempting to fix chronic lateral ankle instability as it relates to the ATFL and CFL integrity. Methods: A retrospective chart review was conducted to assess outcomes of a modified Brostrom procedure to determine underlying reasoning of the need for revision surgery by utilizing results of the anterior drawer and varus tilt tests. The files of these patients were examined via electronic health records to determine the reasoning for surgery. The preoperative and postoperative results of the anterior drawer test (ADT) and varus tilt test were used to examine ATFL and CFL integrity, respectively, in addition to operative notes. Results: 172 patients met criteria having undergone a modified Brostrom dual ligament repair procedure for lateral ankle instability by a single orthopedic foot and ankle surgeon. With a 3.49% revision rate in the patient population, the only similarity found in all of the patients was the presence of a positive varus tilt test indicating the CFL was a major contributor of failed correction via the modified Brostrom procedure. One patient had a positive ADT, and one had a mildly positive ADT. These ADT and varus tests were performed at various time points in the care of the patients. The average length between surgeries was calculated to be 624.2 days. This revision rate is higher than past studies but was limited to a few years under examination. Conclusion: In conclusion, the anterior drawer and varus tilt tests are utilized to determine the integrity of the ATFL and CFL in the lateral ankle ligament complex. In failed modified Brostrom procedures examined, the positive result was consistently in the varus tilt test, indicating that the CFL is the ligament most affected in these patients requiring additional surgery. However, these physical exam tests are only one way to examine the ankle and do not take additional pathologies of the lateral ankle into account. Additional studies are needed to examine long-term outcomes of the modified Brostrom procedure and reasoning for failure.

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
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