Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitazato, Minami-Ku, Sagamihara, Kanagawa, 252-0373, Japan.
Kumazawa Orthopedic Clinic, Tokyo, Japan.
Sci Rep. 2023 Feb 22;13(1):3098. doi: 10.1038/s41598-023-30079-z.
Ankle joint instability after acute lateral ankle sprain (LAS) is an important factor for deciding treatment strategies. Nevertheless, the degree of ankle joint mechanical instability as a criterion for making clinical decisions is unclear. This study examined the reliability and validity of an Automated Length Measurement System (ALMS) in ultrasonography for assessing real-time anterior talofibular distance. Using a phantom model, we tested whether ALMS could detect two points within a landmark following movement of the ultrasonographic probe. Furthermore, we examined whether ALMS was comparable with the manual measurement method for 21 patients with an acute LAS (42 ankles) during the reverse anterior drawer test. Using the phantom model, ALMS measurements showed excellent reliability, with errors below 0.4 mm and with a small variance. The ALMS measurement was comparable to manually measured values (ICC = 0.53-0.71, p < 0.001) and detected differences in talofibular joint distances between unaffected and affected ankles of 1.41 mm (p < 0.001). ALMS shortened the measurement time by one-thirteenth for one sample compared to the manual measurement (p < 0.001). ALMS could be used to standardize and simplify ultrasonographic measurement methods for dynamic joint movements without human error in clinical applications.
急性外踝扭伤（LAS）后踝关节不稳定是决定治疗策略的重要因素。然而，作为制定临床决策的标准，踝关节机械不稳定性的程度尚不清楚。本研究通过超声检查评估实时距腓前韧带（ATFL）距骨前结节距离，检测自动长度测量系统（ALMS）的可靠性和有效性。使用模型，我们测试了 ALMS 是否可以在超声探头移动后检测到标志内的两个点。此外，我们还在反向前抽屉试验中检查了 21 例急性 LAS（42 个踝关节）患者的 ALMS 是否与手动测量方法相当。使用模型，ALMS 测量具有良好的可靠性，误差低于 0.4mm，方差较小。ALMS 测量与手动测量值相当（ICC=0.53-0.71，p<0.001），并且能够检测到距腓关节在健侧和患侧之间的差异为 1.41mm（p<0.001）。与手动测量相比，ALMS 可将一个样本的测量时间缩短至原来的 1/13（p<0.001）。ALMS 可用于标准化和简化临床应用中无人工误差的动态关节运动的超声测量方法。
