Gomes João L Ellera, Soares Arthur F, Bastiani Carlos E, de Castro Jacqueline Vieira
Graduate Program in Surgical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFGRS), Rua Desembargador Esperidião de Lima Medeiros, 81, Porto Alegre, RS, 91330-020, Brazil.
Resident in Orthopaedics and Traumatology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Garibaldi, 894/403, Porto Alegre, RS 90035-051, Brazil.
Foot Ankle Surg. 2018 Dec;24(6):486-489. doi: 10.1016/j.fas.2017.05.006. Epub 2017 Jun 6.
The anterior drawer test is traditionally used to assess ankle instability, but we believe that there is room for a small but effective improvement by adding digital palpation of the talus. We aimed to determine the accuracy of anterolateral talar palpation (ATP) in the diagnosis of ankle instability by comparing it with the traditional anterior drawer test.
Fourteen symptomatic and 10 asymptomatic patients were examined for excessive mobility through comparison of both ankles by two blinded orthopedic surgeons, each one using one of the above-mentioned tests. Symptomatic patients were also referred for stress radiography and magnetic resonance imaging (MRI).
ATP was the most sensitive test, but also the least specific, yielding more positive results than the other tests, including tests with negative MRI. ATP and radiography had the highest accuracy and highest level of agreement with MRI.
ATP significantly improved diagnostic accuracy in detecting ankle instability.
IV: cross-sectional study.
传统上使用前抽屉试验来评估踝关节不稳，但我们认为通过增加对距骨的数字触诊，有空间进行虽小但有效的改进。我们旨在通过将距骨前外侧触诊（ATP）与传统前抽屉试验相比较，来确定其在诊断踝关节不稳中的准确性。
14例有症状患者和10例无症状患者由两名不知情的骨科医生对双侧踝关节进行比较检查，以评估活动过度情况，每位医生使用上述其中一项检查。有症状患者还接受了应力位X线摄影和磁共振成像（MRI）检查。
ATP是最敏感的检查，但特异性最低，比其他检查产生更多阳性结果，包括MRI检查为阴性的情况。ATP和X线摄影与MRI的准确性最高且一致性水平最高。
ATP在检测踝关节不稳方面显著提高了诊断准确性。
IV：横断面研究。
