A new classification of anterior talofibular ligament injuries based on ultrasonography findings

Kemmochi, Masahiko; Sasaki, Shigeru; Fujisaki, Kazuki; Oguri, Yusuke; Kotani, Akihiro; Ichimura, Shoichi

doi:10.1016/j.jos.2016.06.011

Cited by 29 publications

(20 citation statements)

References 23 publications

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“…Patients were seated on the edge of the examination bed with the ankle slightly plantarflexed, inverted, and placed on the examiner's thigh [23,24]. The probe was placed parallel to the sole to visualize the longitudinal view of the ATFL [18,23,24]. Then, the probe was moved proximally and distally to check for avulsion fracture and ATFL injury along the entire width of the ligament [8].…”

Section: Ultrasonographymentioning

confidence: 99%

“…While avulsion fractures generally have a shell-like appearance, subfibular ossicles have a round shape with a cortical margin [3]. ATFL injury was defined as a disruption of the fibrillar pattern of the ligament [18]. The diagnoses were further dichotomized into presence or absence of avulsion fracture.…”

Section: Ultrasonographymentioning

confidence: 99%

“…These characteristics make it particularly suitable for the diagnosis of avulsion fractures of the distal fibula. Additionally, ultrasonography can visualize ligament injuries that cannot be evaluated by radiographs [18]. However, the diagnostic accuracy of ultrasonography in detecting avulsion fractures of the distal fibula has not been clarified or compared with that of radiography.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography

Takakura¹,

Yamaguchi

Akagi

et al. 2020

BMC Musculoskelet Disord

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Background: The purpose of this study was to determine the diagnostic accuracy of ultrasonography for the diagnosis of avulsion fractures of the distal fibula for lateral ankle sprain in children and compare it to that of radiography. Methods: Children who sustained lateral ankle sprain were prospectively surveyed. They underwent both ultrasonography and radiography at the first clinic visit to diagnose any concomitant avulsion fractures of the distal fibula. The patients underwent follow-up radiography 4 weeks later to obtain the reference standard diagnosis. The measures of diagnostic accuracy (i.e., sensitivity, specificity, positive predictive value, and negative predictive value) of the initial ultrasonography and radiography were calculated; they were then compared using the McNemar test. Totally, 52 patients (with a median age of 9 years) were analyzed. Results: On the reference standard (follow-up) radiographs, 32 patients (62%) were found to have avulsion fractures of the distal fibula. The sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography were 94, 85, 91, and 89% respectively; and 81, 100, 100, and 77% respectively for radiography at the first visit. There were no significant differences in sensitivity and specificity between the two diagnostic methods (P = 0.22, 0.25). Conclusions: Ultrasonography has a high diagnostic accuracy, which is comparable to that of radiography, for the diagnosis of avulsion fracture of the distal fibula. Ultrasonography may be used as an option of imaging modality for lateral ankle sprain in children.

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Section: Ultrasonographymentioning

confidence: 99%

Section: Ultrasonographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography

Takakura¹,

Yamaguchi

Akagi

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“… The ATFL originates from the anterior rim of the lateral malleolus and inserts into the anterior part of the talus. It is this ligament which is most often strained when there is inversion of the ankle . The ATFL stretches across, running parallel to the skin with the foot in plantar flexion.…”

Section: Lateral Ankle Anatomymentioning

confidence: 99%

“…The ankle is reported to be the most frequently injured joint in the body with ankle sprains commonly occurring in both the general population and in those playing sports. Ultrasound imaging is reported to play a crucial role in evaluation of ankle ligament thickness and continuity as it is low cost, fast, available and does not use ionising radiation . It can image normal anatomy, evaluate ligament integrity and allow visualisation of dynamic manoeuvres which may increase visibility of tears …”

Section: Ankle Injuriesmentioning

confidence: 99%

Sonography of the ankle: The lateral ankle and ankle sprains

McKiernan

Fenech

Fox³

et al. 2017

Sonography

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Ankle sprains can be considered a relatively common injury particularly from sports injuries. While a sprain is generally a benign injury, symptoms can persist and lead to long-term disability and instability. This article includes an overview of the lateral ankle including ligament and tendon anatomy, scanning technique and information on the common sprains the sonographer may encounter. It is important that sonographers are familiar with the lateral ankle anatomy and potential injuries and how complicated an ankle sprain can be.

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Avulsion fracture is associated with more pain after anatomic repair procedure for ATFL injury at the talar side

Xiong,

Xie,

Shi

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose To evaluate the clinical outcomes of anatomic repair procedure for chronic anterior talofibular ligament (ATFL) injury at the talar side, and to compare the outcomes between patients with and without concomitant avulsion fractures. It was hypothesized that anatomic repair procedure could produce similarly satisfactory outcomes for those two groups. Methods Thirty-nine consecutive patients with chronic ATFL injuries at the talar side who underwent anatomic repair procedure at the department of sports medicine at Peking University Third Hospital between 2013 and 2018, were retrospectively evaluated. The pain visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, Tegner score, and Foot & Ankle Outcome Score (FAOS) were recorded as the primary outcomes. Time to return to sports (RTS), surgical satisfaction, deficiency of ankle range of motion (ROM), recurrent sprain, and postoperative complications were recorded as the secondary outcomes. Outcomes were compared between patients with (Group A, 16 cases) and without (Group B, 23 cases) concomitant avulsion fractures. Results The mean follow-up time was 79.4 ± 17.0 and 76.6 ± 18.5 months for Group A and B, respectively. VAS, AOFAS, Tegner, FAOS, and all subscale scores of FAOS were significantly improved in both groups at the final follow up. Patients in group A had inferior postoperative VAS, AOFAS, FAOS, and pain score of FAOS compared to group B (1.1 ± 1.1 vs. 0.4 ± 0.5, 89.1 ± 10.1 vs. 95.2 ± 5.2, 87.2 ± 7.2 vs. 91. 5 ± 4.1, and 88.4 ± 11.3 vs. 96.7 ± 3.5, respectively).The mean time to RTS, rate of satisfaction and recurrent sprain had no significant differences between group A and B (6.1 ± 2.8, 93.8%, and 18.8% vs. 5.2 ± 2.2, 100.0%, and 13.0%, respectively), and the rate of ROM deficiency was significantly higher in group A (37.5 vs. 8.7%). Avulsion fracture was identified as an independent risk factor for inferior pain score of FAOS. Conclusion Anatomic repair procedure for chronic ATFL injuries at the talar side produces favourable results for patients with and without avulsion fractures at 5 to 10 years follow-up, however, avulsion fracture is associated with more pain. Level of evidence III.

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A new classification of anterior talofibular ligament injuries based on ultrasonography findings

Cited by 29 publications

References 23 publications

Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography

Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography

Sonography of the ankle: The lateral ankle and ankle sprains

Avulsion fracture is associated with more pain after anatomic repair procedure for ATFL injury at the talar side

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