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Ankle Anterior Drawer Test

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1. Reverse anterolateral drawer test is more sensitive and accurate for diagnosing chronic anterior talofibular ligament injury. (PubMed)

Reverse anterolateral drawer test is more sensitive and accurate for diagnosing chronic anterior talofibular ligament injury. To diagnose chronic anterior talofibular ligament (ATFL) injury, three different physical examinations were compared: the anterior drawer test (ADT), the anterolateral drawer test (ALDT), and the reverse anterolateral drawer test (RALDT).A total of 72 ankles from potential ATFL-injured patients and the normal population were included and examined using the ADT, ALDT (...) , and RALDT by two examiners without knowing the injury histories of any of the participants. Ultrasound examination was then applied as the gold standard to divide the ankles into the ATFL-injured group and the control group. The sensitivity (Se), specificity (Sp), false negative rate (FNR), false positive rate (FPR), accuracy, κ value, and p value of the two examiners' diagnoses were calculated to assess the diagnostic ability of each examination.There were 38 ankles in the injured group and 34 ankles

2019 Knee Surgery, Sports Traumatology, Arthroscopy

2. Ankle Anterior Drawer Test

Ankle Anterior Drawer Test Ankle Anterior Drawer Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ankle Anterior Drawer Test Ankle (...) Anterior Drawer Test Aka: Ankle Anterior Drawer Test II. Indications evaluation III. Advantages in evaluation of ankle stability Most sensitive test Least painful test IV. Technique Patient positions foot in slight plantar flexion Brace anterior shin with left hand Pull heel anteriorly with right hand Positive test findings Laxity and poor endpoint on forward translation V. Interpretation of positive test: Grade 2-3 Ankle Sprain Anterior Talofibular ligament rupture Possible Calcaneofibular ligament

2018 FP Notebook

3. Anterolateral Drawer Versus Anterior Drawer Test for Ankle Instability: A Biomechanical Model. (PubMed)

Anterolateral Drawer Versus Anterior Drawer Test for Ankle Instability: A Biomechanical Model. The addition of unconstrained internal rotation to the physical examination could allow for detection of more subtle degrees of ankle instability. We hypothesized that a simulated anterolateral drawer test allowing unconstrained internal rotation of the ankle would provoke greater displacement of the lateral talus in the mortise versus the anterior drawer test.Ten cadaveric lower extremities were (...) tested in a custom apparatus designed to reproduce the anterior drawer test and the anterolateral drawer test, in which the ankle was allowed to internally rotate about the intact deep deltoid ligament while being subluxed anteriorly. Specimens were tested intact and with anterior tibiofibular ligament sectioned. A differential variable reluctance transducer was used to measure lateral talar displacement with anterior forces of 25 and 50 N.No significant differences in talar displacement or ankle

2015 Foot & Ankle International

4. Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy. (PubMed)

Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy. Clinicians frequently diagnose chronic ankle instability using the manual anterior drawer test and stress radiography. However, both examinations can yield incorrect results and do not reveal the extent of ankle instability. Stress ultrasound has been reported to be a new diagnostic tool for the diagnosis of chronic (...) ankle instability. The purpose of this study was to assess the diagnostic value of stress ultrasound for chronic ankle instability compared to the manual anterior drawer test, stress radiography, magnetic resonance imaging (MRI), and arthroscopy.Twenty-eight consecutive patients who underwent ankle arthroscopy and subsequent modified Broström repair for treatment of chronic ankle instability were included. The arthroscopic findings were used as the reference standard. A standardized physical

2015 Knee Surgery, Sports Traumatology, Arthroscopy

5. New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test, stress radiography and stress ultrasound. (PubMed)

New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test, stress radiography and stress ultrasound. To diagnose chronic ankle instability, clinicians frequently use manual anterior drawer test and stress radiography. However, both exams can yield incorrect results and do not reveal the extent of ankle instability. The use of stress ultrasound during a manual anterior drawer stress procedure might enable the diagnosis of chronic ankle instability.Seventy (...) -three patients with chronic ankle pain or laxity after remote ankle sprain were included. The study population included 41 males and 32 females. The mean age of the patients at the time of the operation was 29 years. A standardized physical examination (manual anterior drawer test), stress radiography and stress ultrasonography were performed to assess the anterior talofibular ligament (ATFL). Ultrasound images were taken in the resting position and the maximal anterior drawer position

2014 Knee Surgery, Sports Traumatology, Arthroscopy

6. Clinical outcomes of a modified all-inside arthroscopic repair of anterior talofibular ligament for chronic ankle instability: A preliminary report. (PubMed)

-inside arthroscopic repair. The function was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analog score (VAS) score system, the Sefton grading system, and the anterior drawer test and talar tilt test. A total of 29 cases (30 ankles) were followed up for a mean of 33.7 ± 4.5 (range 30-44) months. Based on the Sefton grading system, 12 patients were regarded as excellent, 13 were good, 2 were fair, and 2 were poor. Twenty-five cases (86.2%) achieved satisfactory (...) Clinical outcomes of a modified all-inside arthroscopic repair of anterior talofibular ligament for chronic ankle instability: A preliminary report. The present study was conducted to evaluate the clinical outcomes of a modified all-inside arthroscopic repair technique via anterolateral and accessory anterolateral port for anterior talofibular ligament (ATFL) repair. A consecutive series of 32 patients (34 ankles) with chronic ankle instability were included and treated with the modified all

2019 Medicine

7. Ankle Anterior Drawer Test

Ankle Anterior Drawer Test Ankle Anterior Drawer Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ankle Anterior Drawer Test Ankle (...) Anterior Drawer Test Aka: Ankle Anterior Drawer Test II. Indications evaluation III. Advantages in evaluation of ankle stability Most sensitive test Least painful test IV. Technique Patient positions foot in slight plantar flexion Brace anterior shin with left hand Pull heel anteriorly with right hand Positive test findings Laxity and poor endpoint on forward translation V. Interpretation of positive test: Grade 2-3 Ankle Sprain Anterior Talofibular ligament rupture Possible Calcaneofibular ligament

2015 FP Notebook

8. Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability. (PubMed)

(range, 24-40 months). At final follow-up, all patients had returned to activity without instability, pain, or limited range of motion. On stress radiography, mean talar tilt angle decreased from 17.32° ± 3.58° before surgery to 4.16° ± 1.12° at follow-up (p < 0.001). Mean anterior drawer test (ADT) distance decreased from 9.79 ± 1.01 mm before surgery to 3.97 ± 0.99 mm at follow-up (p < 0.05). Mean AOFAS improved from 64.00 ± 18.43 to 90.32 ± 5.17 points (p < 0.001), and mean KAFS improved from (...) Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability. The purpose was retrospectively to investigate functional and clinical outcomes after anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) reconstruction using a single allograft.Patients with severe chronic lateral instability of the ankle underwent surgery after conservative treatment failed. Ultrasounds of the ankle were performed

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2017 BMC Musculoskeletal Disorders

9. Radiography of the Ankle and Foot (Ottawa Ankle Rules)

, the Alberta Clinical Practice Guideline Program, in 1996 as a guideline to assist physicians to make decisions about use of radiography for patients with ankle injuries. The Ottawa Ankle Rules were developed, clinically tested and demonstrated that the use of these rules decreased ankle radiography use, waiting times, and costs without patient dissatisfaction or missed fractures. The investigator, Dr. Ian Stiell, a clinical epidemiologist with a focus on health services research in emergency medicine, led (...) of swelling in four locations, anterior drawer sign and ability to bear weight for at least four steps in the emergency department. The best agreement was judging ability to bear weight and good agreement judging bone tenderness. Findings related to ecchymosis, range of motion, soft tissue tenderness and anterior drawer sign were unreliable. The interobserver agreement was most reliable for bearing weight for four steps in the emergency department, swelling of the lateral malleolus, localized bone

2014 Toward Optimized Practice

10. Detecting ankle instability with an instrumented ankle arthrometer - an experimental study. (PubMed)

Detecting ankle instability with an instrumented ankle arthrometer - an experimental study. A new instrumented device was developed to quantify ankle joint stability during an anterior talar drawer test. The aim of the present study was to validate this device comparing bone kinematics with arthrometer measurement outcomes. An anterior talar drawer test was performed with 14 cadaver legs using a custom instrumented ankle arthrometer. Using clusters of bone-pin markers, the relative three (...) characteristic curves indicates a fair to good ability to discriminate between the intact and the sectioned conditions with the arthrometer. Distal distraction, inversion, and internal rotation movements were observed when two and three ligaments were cut. Results revealed that the ankle arthrometer was sensitive to detect changes in bone-to-bone movements during an anterior talar drawer test, when the anterior talofibular ligament was sectioned. Presumably due to movements in additional planes of motion

2019 Journal of Orthopaedic Research

11. Inverse Relationship Between Radiographic Lateral Ankle Instability and Osteochondral Lesions of the Talus in Patients With Ankle Inversion Injuries. (PubMed)

ankle inversion injuries.A total of 195 patients (113 men and 83 women; mean age, 38.7 years) with a history of ankle inversion injuries were included in this study. All patients underwent ankle magnetic resonance imaging (MRI) and stress radiography. The tibiotalar tilt angle on varus stress radiograph, anterior translation of the talus on anterior-drawer lateral radiographs, bimalleolar tilt angle, and fibular position were radiographically determined. The radiographic lateral ankle instability (...) was defined as tibiotalar tilt angle ≥10 degrees, and the presence of OLT was confirmed on MR images. The relationship between the radiographic lateral ankle instability and the presence of OLT was statistically analyzed.The presence of radiographic lateral ankle instability (tibiotalar tilt angle ≥10 degrees) showed an inverse relationship with that of OLT in the chi-squared test (P = .003). An increased tibiotalar tilt angle was associated with lower incidence of OLT (P = .011) in the multiple

2019 Foot & Ankle International

12. CRACKCast E058 – Ankle and Foot

to instability Clinical FEATURES: History: mechanism of injury; onset of pain and swelling; weight bearing ability; “pop” noise 2) List Ankle stress tests Phyiscal exam: LOOK; FEEL pulses/max tenderness areas/sensation; MOVE + weight bear Frequently missed injuries: ?syndesmosis, fibular head #, fifth MT #, achilles tendon rupture; peroneal tendon rupture Stress tests: Of questionable significance in the ER Potential utility in a distal fibular fracture with deltoid complex pain Anterior drawer test Assesses (...) injuries: Ligament injuries: AntTFL > CalcFL > > PostTFL Grade I: stretching without tearing or joint instability Grade II: partial tear, SWELLING PAIN, and mod. instability Grade III: complete tear, severe edema and ecchymosis. Inability to wt. bear = grade 2/3 injury if no # **Must exclude deltoid ligament or syndesmosis injury** Ligament stress testing is moderately useful, and should be compared bilaterally Anterior drawer/talar tilt/external rotation test: lateral ligament injuries Look

2017 CandiEM

13. Chronic Ankle Pain

as “Varies”. Supporting Documents For additional information on the Appropriateness Criteria methodology and other supporting documents go to www.acr.org/ac. References 1. Cho JH, Lee DH, Song HK, Bang JY, Lee KT, Park YU. Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2016;24(4):1022-1028. 2. Dowling LB, Giakoumis M, Ryan JD. Narrowing (...) . New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test, stress radiography and stress ultrasound. Knee Surg Sports Traumatol Arthrosc. 2014;22(7):1701-1707. 60. Christodoulou G, Korovessis P, Giarmenitis S, Dimopoulos P, Sdougos G. The use of sonography for evaluation of the integrity and healing process of the tibiofibular interosseous membrane in ankle fractures. J Orthop Trauma. 1995;9(2):98-106. ACR Appropriateness Criteria ® 16 Chronic Ankle Pain 61

2017 American College of Radiology

14. Ankle and Foot Surgical Guideline

Ligament Repair/ Reconstruction e.g. Br?strom procedure, Watson- Jones procedure Severe ankle sprain or recurrent sprains leading to instability A discrete documented work-related ankle injury AND Ankle “gives way” OR Swelling OR Difficulty walking on uneven ground Positive instability testing: e.g. Anterior drawer testing OR Asymmetric inversion laxity (when compared to contralateral side) Bilateral stress X-rays w/ asymmetrical stress tests: Talar tilt > 10 degrees OR Anterior displacement index (...) such as Thompson, Squeeze, External Rotation Stress, Anterior Drawer, and the Talar Tilt test. 37 In addition to performing a thorough exam, it is critical to get an accurate history of injury occurrence, previous injuries, and underlying comorbidities/ risk factors, which may predispose the worker to further foot and ankle injury. A. Imaging The recommended imaging procedures for various foot and ankle surgeries are specified in the criteria table. Weight bearing x-rays are recommended when determining

2017 Washington State Department of Labor and Industries

15. Ankle Taping and Functional Ankle Instability

for Study: 20 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: participants had to have sustained at least two ankle sprain from a sudden inversion trauma, at least one month prior, which resulted in pain and swelling over the lateral ligament and limping, and have at least moderate functional ankle instability a score of <27 on the Cumberland Ankle Instability Tool (CAIT) anterior drawer test: negative talar tilt test (...) functional mobility tests with and without the ankle taped. The functional tests are: figure-8 hopping test, lateral hopping test, star excursion balance test (SEBT), single-leg stance and stair decent test. Secondary outcome measures were self-efficacy and perception measure. Statistics: Two-way analysis of variance with repeated measures was used to determine the effects of intervention on each dependent variable. Model effects were group, time (pre, post), and their interaction. Post hoc pairwise

2017 Clinical Trials

16. All-Inside Single-Bundle Reconstruction of the Anterior Cruciate Ligament with the Anterior Half of the Peroneus Longus Tendon Compared to the Semitendinosus Tendon: A Two-Year Follow-Up Study. (PubMed)

randomized controlled study was performed to compare the results of 62 cases of all-inside anatomical single-bundle anterior cruciate ligament (ACL) reconstruction using the AHPLT and 62 cases using semitendinosus graft with an average of 30.0 ± 3.6 months' follow-up. Tunnel placements of enrolled cases were measured on three-dimensional (3D) computed tomography (CT) and X-ray imaging. Knee stability was assessed using the anterior drawer test, pivot shift test, and KT-1000. The International Knee (...) 1000 measurements (1.71 ± 0.57 vs. 1.85 ± 0.77), pivot shift test, and Visual Analogue Scale (VAS) (0.15 ± 0.36 vs. 0.10 ± 0.30). No obvious ankle site complications were found at 24 months. The average AOFAS score of the AHPLT group was comparable to that of the semitendinosus tendon group (99.1 ± 1.40 vs. 99.5 ± 1.21). There was no significant difference in clinical outcomes or knee stability between the semitendinosus group and the AHPLT group at the 2-year follow-up. An AHPLT autograft may

2018 The journal of knee surgery

17. Posterolateral ankle ligament injuries affect ankle stability: a finite element study. (PubMed)

Posterolateral ankle ligament injuries affect ankle stability: a finite element study. We have already discovered 23 patients during the work of the outpatient department and operations whose unstable signs on the posterolateral ankle. The anterior drawer test demonstrated normal during the physical examinations while the spaces of the posterior tibiotalar joints increased in stress X-ray plain films. ATFL intact and posterolateral ligaments lax were found during operations too. It is important (...) to make existence claims and illuminate the mechanism of posterolateral ankle instability.A finite element model of the ankle was established for simulating to cut off posterolateral ligaments in turn. Ankle movements with tibia rotation under load on five forefoot positions were simulated as well.The difference values with tibia external rotation were negative, and the positive results occurred with tibia internal rotation. The tibia-talus difference values in some forefoot positions were 2 ~ 3 mm

Full Text available with Trip Pro

2016 BMC Musculoskeletal Disorders

18. Medial malleolar stress fracture resulting from repetitive stress caused by lateral ankle instability: A case report. (PubMed)

using tension bend wiring, and an arthroscopic modified Broström procedure was done.Two months postoperatively, the patient started walking, and raised-heel squatting. The medial malleolar fracture was completely united at the 3 months postoperatively on plain radiography, and return to full activity was achieved by 3 months postoperatively. Then the hardware was removed 1-year after operation and both the anterior drawer and external rotation stress tests were negative.Medial malleolar stress (...) showed a vertical fracture line in the medial malleolus. Computed tomography also showed the vertical fracture in the medial malleolus. Magnetic resonance imaging revealed mild bone marrow edema in the medial malleolar area and total rupture of the anterior talofibular ligament.Surgery was performed under general anesthesia, and we checked the instability of his ankle using a C-arm image intensifier, and the varus talar tilt angle was increased (10.3°). The medial malleolus stress fracture was fixed

2019 Medicine

19. Arthroscopic all-inside ATFL and CFL repair is feasible and provides excellent results in patients with chronic ankle instability. (PubMed)

knotless anchors, both fascicles of the ATFL and the CFL were repaired.Arthroscopic examination demonstrated ATFL and CFL injuries in all patients. Subjective improvement in their ankle instability was observed postoperatively. The anterior drawer and the talar tilt tests were negative at follow-up. The median AOFAS score increased from 65 (mean 65, range 52-85) preoperatively to 97 (mean 97, range 85-100) at final follow-up.Chronic ankle instability with concomitant injury of both the ATFL and CFL (...) Arthroscopic all-inside ATFL and CFL repair is feasible and provides excellent results in patients with chronic ankle instability. Chronic ankle instability has been described as presenting with complete tears of both the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in 20% of cases. Arthroscopic techniques to treat chronic ankle instability are increasingly being reported and in some instances they can be technically demanding. The aim of this study was to describe

2019 Knee Surgery, Sports Traumatology, Arthroscopy

20. Arthroscopic Versus Open Brostrom for Ankle Instability

(Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Individuals must be older than 18 and younger than 65 years of age, both genders; Participants must be experiencing instability symptoms at the ankle over the last six months; Clinical diagnosis of ankle instability, defined as the presence of at least one previous ankle sprain associated with a current instability sensation by the patient and the presence of a positive anterior drawer test (...) ), American Orthopedic Foot and Ankle Society (AOFAS), the Visual Analogue Scale (VAS), the Foot Function Index (FFI) and the 36 Item Short Form Health Survey (SF-36). The investigators will use Comparison of Two Proportions via relative frequency analysis, the Pearson Correlation the Chi-Square test and the ANOVA for statistical analyses. Discussion: This study intends to establish if the arthroscopic Brostrom technique can produce excellent and reliable results when treating chronic ankle instability

2018 Clinical Trials

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