Ankle instability: evaluation of the lateral ligaments

Abstract

Bilateral ankle stress testing was performed on 25 subjects in a device which controlled position of the foot and the amount of force applied during the examination. Both inversion testing in the anteroposterior plane and anterior drawer testing in the lateral plane were performed in the same group of symptom-free patients. The reproducibility of the test was demonstrated. Previous history of injury, left vs. right handedness, side and anthropometric measurements did not affect the test. There was no difference in the inversion test between ankles tested in neutral and plantar flexion. In functionally normal ankles, the range of inversion "talar tilt" was 0 to 18 degrees while the maximum of anterior displacement on drawer testing was 3 mm. The effective stiffness of the anterior talofibular ligament was thus computed as 65 +/- 34 N/m. Anterior drawer testing appears to evaluate lateral ligamentous integrity of the ankle more critically than the talar tilt test.

Validity and reliability of a self-administered foot evaluation questionnaire (SAFE-Q)

“…The nine items of the Sports Activity subscale of the SAFE-Q consist of questions about very basic performance of sports activities [8, 19, 20]. Regarding the Sports Activity subscale, the unidimensionality of the items remained stable and the difference between patients and non-patients was apparent.…”

Radiographic Instability of the Ankle Joint After Evans' Repair

“…In addition to clinical examination, stress radiographs have been proved to be reliable for examination of ligamentous lesions of the ankle joint (Seligson et al 1980, Adler 1982. The correlation of the anterior drawer sign with the degree of seriousness of the ankle injury or with the operative findings is considered to be better than talar tilt angle measurements (Lindstrand 1976, Hackenbruch et al 1979).…”

Current concepts on the pathophysiology and management of recurrent ankle sprains and chronic ankle instability

“…Alterations in arthrokinematics, joint laxity, and synovial and degenerative changes of the joints have been reported in patients with recurrent ankle sprains and CAI [25,31,33]. Common clinician assessment includes the use of ligamentous stress test such as the anterior drawer and talar tilt test [34]. The mechanical laxity may lead to further aberrant motion at the joint, resulting in long term osteoarthritic changes.…”