Kemen M, Ernst R, Bauer K H, Weber A, Zumtobel V
Chirurgische Klinik, St. Josef-Hospital, Ruhruniversität Bochum.
Unfallchirurg. 1991 Dec;94(12):614-8.
Chronic instability of the lateral upper ankle joint ligament is usually diagnosed by clinical and radiological examination. For the evaluation of an ultrasound method of testing lateral instability of the ankle joint we carried out a prospective study. We examined 23 adults who were actively engaged in some form of sport (21 male, 2 female, mean age 32 years) and had a preexisting lateral instability of the ankle. The instability was measured in the standard planes using Scheuba's stress apparatus with simultaneous ultrasound monitoring. The ultrasound examination was performed by positioning the 5-MHz applicator on the lateral side of the Achilles tendon, thus defining a plane from which the instability could be measured in both examination planes by observing the deviation between dorsal inferior edge of the tibia and the dorsal border of the talar roll. For the two examination planes, Spearman's rank-correlation coefficient between the radiological and ultrasound methods was 0.83 and 0.92. The sensitivity of the ultrasound method was 0.90, and the specificity was 0.85. Our study showed a good correlation between the two methods. A pathological talar tilt according to radiological criteria was also revealed by ultrasonography. Thus, all the advantages of ultrasound are now available for the evaluation of chronic lateral instability of the ankle joint.
踝关节外侧上韧带慢性不稳定通常通过临床和影像学检查来诊断。为了评估一种检测踝关节外侧不稳定的超声方法,我们进行了一项前瞻性研究。我们检查了23名积极参与某种形式运动的成年人(21名男性,2名女性,平均年龄32岁),他们此前存在踝关节外侧不稳定。使用朔伊巴应力仪在标准平面测量不稳定情况,并同时进行超声监测。超声检查是将5兆赫探头置于跟腱外侧,从而确定一个平面,通过观察胫骨背侧下缘与距骨滚动背侧边缘之间的偏差,在两个检查平面测量不稳定情况。对于两个检查平面,影像学方法与超声方法之间的斯皮尔曼等级相关系数分别为0.83和0.92。超声方法的敏感性为0.90,特异性为0.85。我们的研究表明这两种方法之间具有良好的相关性。超声检查还显示出符合影像学标准的病理性距骨倾斜。因此,超声的所有优点现在都可用于评估踝关节外侧慢性不稳定。