Use of a comprehensive systemic ultrasound evaluation in the diagnosis and analysis of acute lateral region ankle sprain

Abstract

Background For the diagnosis of acute lateral ankle sprain, many clinicians use ultrasound; they typically focus on the lateral ligament complex, which is the most common site of lesions in ankle sprain. However, this approach risks missing other foot and ankle lesions. The present study aimed to provide and analyze the results of a new ultrasound method of diagnosis for acute lateral ankle sprain which can thoroughly investigate overall lesions of the foot and ankle. Methods Retrospective cross-sectional cohort study of 123 patients who underwent diagnostic ultrasound within 1 week of acute lateral ankle injury was performed. Causes of ankle sprain, incidence and severity of each ligament injury, location of anterior talofibular ligament (ATFL) injury, accompanying ligament injury, and occult fracture were analyzed. Results Among the 102 cases of ATFL injuries, 60 (58.5%) had islolated ATFL injury, 28 (27.5%) had accompanying calcaneofibular ligament injury (CFL), and 14 (13.7%) had accompanying midtarsal or syndesmosis injury. ATFL injuries occurred on the fibula attachment in 48 (47.1%) cases, ligament mid-substance in 24 (23.5%) cases, and talus attachment in 30 (29.4%) cases. Among the 165 lesions from 123 cases, injuries of the fourth or fifth dorsal tarsometatarsal (12 cases, 7.3%), bifurcate (11 cases, 6.7%), and anterior tibiofibular (11 cases, 6.7%) ligaments were not rare. Conclusion These findings suggest that an ultrasound examination involving investigation of the midtarsal joint and syndesmotic ligament, as well as the ATFL and CFL, is useful for comprehensive, systemic diagnosis of acute lateral ankle sprain.

Correlation between Ankle Imaging Findings and Self-Reported Outcomes: A Longitudinal Assessment in Patients with Tibiofibular Diastasis

“…(3) all fractures were classified according to the International Classification of Diseases (ICD-10) [23] and further categorized using the Danis-Weber and Lauge-Hansen grading systems into specific fracture types (SER, PER, SA, PA); (4) patients were divided into two groups: those who underwent syndesmotic screw fixation as part of their initial fracture treatment (and subsequently had the screw removed) and those treated conservatively without screw fixation (Non-Screw Removal Group); (5) the patients had to be present for evaluation at two time points that were set at 2 and 6 months post-operatively to assess short-term and medium-term outcomes; (6) mandatory post-operative rehabilitation must be undertaken by all participants; (7) decisions to remove or retain the talofibular syndesmotic screw were taken by the patients after careful consideration of the medical advice provided by the orthopedic surgeon.…”

“…Techniques such as X-ray, MRI, and CT scans have revolutionized the understanding and management of distal tibiofibular injuries, guiding both conservative approaches and surgical interventions [5][6][7][8][9][10][11]. Nevertheless, clinical evaluation, though vital, might not always correlate with patient experiences, functional outcomes, or their overall perception of well-being [12,13].…”