Stress Radiographs Under Anesthesia for Painful Chronic Lateral Ankle Instability

• Main Authors: Jun Young Choi MD, Jin Soo Suh MD, PhD
• Format: Article
• Language: English
• Published: SAGE Publishing 2017-09-01
• Series: Foot & Ankle Orthopaedics
• Online Access: https://doi.org/10.1177/2473011417S000139

Category: Ankle Introduction/Purpose: Anterior drawer and varus stress radiographs are commonly used for chronic lateral ankle instability. We compared pre-operative stress radiographs to intra-operative ones under anesthesia to figure out the accuracy and efficacy of stress radiographs at outpatient clinic. Methods: Data was collected from the patients underwent Modified Broström operation for painful chronic unilateral lateral ankle instability from January, 2014 to June, 2016. Subjects were divided by three groups (complete tear, partial tear and instability without rupture) according to the status of preoperative MRI findings of anterior talofibular ligament. Results: Ninety six patients were enrolled with a mean age of 29.63±12.04 (male: female=65: 31). Complete, partial tear and instability without rupture were 39, 46 and 11 respectively. On anterior drawer and varus stress radiographs on the affected limb, talar translation and tilting were increased significantly (2.57 mm and 2.01o). The differences between the unaffected limbs were increased by 2.47 mm and 1.32 o. Despite the stress radiographs were performed under anesthesia, the results often showed relatively small value which was not matched to the diagnostic value, even for complete tear group. Conclusion: Stress radiographs for chronic painful unilateral lateral ankle instability performed at outpatient clinic would be inaccurate. Therefore, additional diagnostic tools such as, ultrasonography or MRI are highly necessary.