Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.

Hdl Handle:
http://hdl.handle.net/10147/252274
Title:
Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.
Authors:
Henari, Shwan; Banks, Louisa N; Radovanovic, Ingrid; Queally, Joseph; Morris, Seamus
Affiliation:
Department of Trauma and Orthopedics, Adelaide and Meath Hospital, Dublin, Ireland. shwanhenari@hotmail.com
Citation:
Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle. 2011, 34 (10):e639-43 Orthopedics
Publisher:
Orthopedics
Journal:
Orthopedics
Issue Date:
Oct-2011
URI:
http://hdl.handle.net/10147/252274
DOI:
10.3928/01477447-20110826-11
PubMed ID:
21956059
Abstract:
The medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (χ(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service.
Item Type:
Article
Language:
en
MeSH:
Adolescent; Adult; Aged; Ankle Injuries; Ankle Joint; Female; Humans; Intra-Articular Fractures; Ligaments, Articular; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Range of Motion, Articular; Reproducibility of Results; Rotation; Rupture; Supination; Tibia; Ultrasonography; Young Adult
ISSN:
1938-2367

Full metadata record

DC FieldValue Language
dc.contributor.authorHenari, Shwanen_GB
dc.contributor.authorBanks, Louisa Nen_GB
dc.contributor.authorRadovanovic, Ingriden_GB
dc.contributor.authorQueally, Josephen_GB
dc.contributor.authorMorris, Seamusen_GB
dc.date.accessioned2012-11-15T15:49:49Z-
dc.date.available2012-11-15T15:49:49Z-
dc.date.issued2011-10-
dc.identifier.citationUltrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle. 2011, 34 (10):e639-43 Orthopedicsen_GB
dc.identifier.issn1938-2367-
dc.identifier.pmid21956059-
dc.identifier.doi10.3928/01477447-20110826-11-
dc.identifier.urihttp://hdl.handle.net/10147/252274-
dc.description.abstractThe medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (χ(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service.en_GB
dc.language.isoenen
dc.publisherOrthopedicsen_GB
dc.rightsArchived with thanks to Orthopedicsen_GB
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAnkle Injuries-
dc.subject.meshAnkle Joint-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIntra-Articular Fractures-
dc.subject.meshLigaments, Articular-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshProspective Studies-
dc.subject.meshRange of Motion, Articular-
dc.subject.meshReproducibility of Results-
dc.subject.meshRotation-
dc.subject.meshRupture-
dc.subject.meshSupination-
dc.subject.meshTibia-
dc.subject.meshUltrasonography-
dc.subject.meshYoung Adult-
dc.titleUltrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Trauma and Orthopedics, Adelaide and Meath Hospital, Dublin, Ireland. shwanhenari@hotmail.comen_GB
dc.identifier.journalOrthopedicsen_GB
dc.description.provinceLeinsteren

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