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重力应力位下超声评估外踝旋转松弛度:未受伤踝关节的正常值

The evaluation of rotational lateral ankle laxity in gravity stress position by ultrasonography: normative value in uninjured ankles.

作者信息

Yokoe Takuji, Yang Fan, Tajima Takuya, Chosa Etsuo

机构信息

Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, Kihara, Kiyotake, 5200, 889-1692, Miyazaki, Japan.

出版信息

BMC Musculoskelet Disord. 2024 Oct 1;25(1):764. doi: 10.1186/s12891-024-07881-5.

Abstract

BACKGROUND

The evaluation of lateral ankle laxity remains challenging when diagnosing chronic lateral ankle instability (CLAI). Several studies have reported that internal rotation of the talus as an indicator of rotational lateral ankle laxity (RLAL) increases in patients with CLAI. However, there is no established method for detecting and evaluating the RLAL. This study aimed to report a novel method for evaluating the RLAL in the gravity stress position by measuring the talofibular distance (TFD) using ultrasonography (US) and show the normative value of the TFD.

METHODS

The TFDs in the subjects with healthy ankles were prospectively measured 10 mm distal to the ankle joint in the neutral ankle position and gravity stress position using US. The differences in the TFD between the two ankle positions were evaluated. The differences in the TFD by gender and ankle laterality were also evaluated.

RESULTS

A total of 52 healthy ankles of 28 subjects (mean age, 24.0 ± 1.6; male/female, 12/16) were finally included. There was a significant difference in the TFD between the neutral ankle position (6.9 ± 0.9 mm) and gravity stress position (9.0 ± 0.9 mm) (p < 0.001). The mean difference in the TFD between the two ankle positions was 2.1 ± 0.6 mm. There were no significant differences in the TFD by gender and ankle laterality.

CONCLUSIONS

The present study reported a novel US method for evaluating RLAL by applying gravity stress and the normative value of the TFD.

摘要

背景

在诊断慢性外侧踝关节不稳(CLAI)时,评估外侧踝关节松弛度仍然具有挑战性。多项研究报告称,距骨内旋作为旋转性外侧踝关节松弛(RLAL)的指标,在CLAI患者中增加。然而,目前尚无检测和评估RLAL的既定方法。本研究旨在报告一种通过超声(US)测量距腓距离(TFD)来评估重力应力位下RLAL的新方法,并展示TFD的正常参考值。

方法

前瞻性地使用US测量健康踝关节受试者在踝关节中立位和重力应力位时踝关节远端10 mm处的TFD。评估两个踝关节位置之间TFD的差异。还评估了TFD在性别和踝关节左右侧别上的差异。

结果

最终纳入了28名受试者的52个健康踝关节(平均年龄24.0±1.6岁;男/女,12/16)。踝关节中立位(6.9±0.9 mm)和重力应力位(9.0±0.9 mm)之间的TFD存在显著差异(p<0.001)。两个踝关节位置之间TFD的平均差异为2.1±0.6 mm。TFD在性别和踝关节左右侧别上无显著差异。

结论

本研究报告了一种通过施加重力应力评估RLAL的新型US方法以及TFD的正常参考值。

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