Standing on single foot-binding test yields satisfactory results as a novel method for the diagnosis of distal tibiofibular syndesmosis instability: a prospective, cross-sectional diagnostic-accuracy study

Review written by Dr Chris Bleakley info

Key Points

  1. 20-30% of ankle injuries affect the distal syndesmosis (tibiofibular joint), but existing clinical tests cannot accurately assess joint stability.
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BACKGROUND & OBJECTIVE

Instability (diastasis) at the distal ankle syndesmosis can result after injury and may be due to laxity of any of the following ligaments: anterior inferior tibiofibular ligament (AITFL), interosseus ligament (IOL), posterior inferior tibiofibular ligament (PITFL), transverse tibiofibular ligament (TTFL). Although many physical examination tests have been described for the ankle syndesmosis, their diagnostic positivity is based primarily on pain provocation. The current gold standard for diagnosing syndesmotic instability is arthroscopy, but as this is invasive and expensive, it is important to develop non-invasive alternatives.

In this study, Sun et al. describes a new method for diagnosing instability at the distal tibiofibular syndesmosis, comparing its accuracy with commonly used alternatives (MRI and palpation), and the gold standard reference (arthroscopy).

The current gold standard for diagnosing syndesmotic instability is arthroscopy, but as this is invasive and expensive, it is important to develop non-invasive alternatives.
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This new test compares favourably to the current reference standard (arthroscopy) with good levels of both sensitivity and specificity.

METHODS

  • Patients with a history of ankle sprain were recruited from an orthopaedic department in China.
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