Syndesmotic Ankle Sprains: Difference between revisions
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== Examination == | == Examination == | ||
<br>Special Test | |||
*<u>Hx</u>: chronic pain, prolonged recovery, recurrent sprains, and the formation of heterotopic ossification within the interosseous membrane( Prospective Evaluation of SyndesmoticAnkle Sprains Without Diastasis*) | |||
*<u>MOI</u>: External rotation and excessive dorsiflexion of the foot on the leg have been reported as the most common mechanism of injury (JOSPT Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention. 2006 Jun;36(6):372-84. | |||
*<u>Observation/Gait analysis</u>: Check for discrepancies | |||
*<u>Palpation</u>:tenderness proximally over the anterior tibiofibular ligament and proximal along the interosseous membrane (anterior lateral ankle pain directly over the anterior syndesmosis- syndesmotic ankle sprains in atheletes) | |||
- Palpate the medial and lateral malleoli for exidence of a fracture (CLINICAL REVIEW- Syndesmosis Ankle SPRAIN)<br> - Fibula needs to be palpated from distal to proximal, including the proximal tibiofibular joint to rule out Maissoneuve’s fracture . (Syndesmotic ankle sprains in athletes) | |||
*<u>Distal Pulses</u>: Ensure pedal pulses are present (CLINICAL REVIEW SYNDESMOSIS ANKLE SPRAIN) | |||
*<u>Girth Measurements</u>: Notable swelling of ankle, make sure to measure | |||
*<u>Special Test</u>: | |||
'''External Rotation''' '''Test''' (Kleiger’s Test) (Evaluation handbook- chad starkey)<br>- Is used to determine a rotator damage to the deltoid ligament or the distal tibiofibular syndesmosis. The implication is based on the area of pain. Tibiofibular syndesmotic ankle sprain will experience pain in the anterolateral ankle compared to a displacement of the talus away from the medial malleolus.<br>- Interrater kappa= 0.75 (best)- Clinical tests for Ankle Syndesmosis Injury: reliability and prediction of return to function 1998<br>- Test that gives the best interrater reliability (Syndesmotic ankle sprains in athletes) | |||
'''Squeeze Test'''- separation of the tibia and fibula (Evaluation Handbook)<br>- Identifies a fibular fracture or syndesmosis sprain. Pain will be reproduced along the fibular shaft if it’s a fibular fracture and the distal tibiofibular jt for syndesmosis sprain.<br>- interrater= 0.5 (moderate) Clinical tests for Ankle Syndesmosis Injury: reliability and prediction of return to function 1998<br>'''Cotton Test''' (Magee)<br>- Assess for syndesmosis instability with diastasis.<br>- Performed: steadying the distal leg with one hand while grasping the plantar hell with the opposite hand and moving the heel directly from side to side (Syndesmotic ankle sprain in athletes)<br>- (+) any lateral translation would indicate syndesmotic instability (Magee)<br> | '''Squeeze Test'''- separation of the tibia and fibula (Evaluation Handbook)<br>- Identifies a fibular fracture or syndesmosis sprain. Pain will be reproduced along the fibular shaft if it’s a fibular fracture and the distal tibiofibular jt for syndesmosis sprain.<br>- interrater= 0.5 (moderate) Clinical tests for Ankle Syndesmosis Injury: reliability and prediction of return to function 1998<br>'''Cotton Test''' (Magee)<br>- Assess for syndesmosis instability with diastasis.<br>- Performed: steadying the distal leg with one hand while grasping the plantar hell with the opposite hand and moving the heel directly from side to side (Syndesmotic ankle sprain in athletes)<br>- (+) any lateral translation would indicate syndesmotic instability (Magee)<br> | ||
Revision as of 16:19, 7 July 2011
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Examination[edit | edit source]
- Hx: chronic pain, prolonged recovery, recurrent sprains, and the formation of heterotopic ossification within the interosseous membrane( Prospective Evaluation of SyndesmoticAnkle Sprains Without Diastasis*)
- MOI: External rotation and excessive dorsiflexion of the foot on the leg have been reported as the most common mechanism of injury (JOSPT Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention. 2006 Jun;36(6):372-84.
- Observation/Gait analysis: Check for discrepancies
- Palpation:tenderness proximally over the anterior tibiofibular ligament and proximal along the interosseous membrane (anterior lateral ankle pain directly over the anterior syndesmosis- syndesmotic ankle sprains in atheletes)
- Palpate the medial and lateral malleoli for exidence of a fracture (CLINICAL REVIEW- Syndesmosis Ankle SPRAIN)
- Fibula needs to be palpated from distal to proximal, including the proximal tibiofibular joint to rule out Maissoneuve’s fracture . (Syndesmotic ankle sprains in athletes)
- Distal Pulses: Ensure pedal pulses are present (CLINICAL REVIEW SYNDESMOSIS ANKLE SPRAIN)
- Girth Measurements: Notable swelling of ankle, make sure to measure
- Special Test:
External Rotation Test (Kleiger’s Test) (Evaluation handbook- chad starkey)
- Is used to determine a rotator damage to the deltoid ligament or the distal tibiofibular syndesmosis. The implication is based on the area of pain. Tibiofibular syndesmotic ankle sprain will experience pain in the anterolateral ankle compared to a displacement of the talus away from the medial malleolus.
- Interrater kappa= 0.75 (best)- Clinical tests for Ankle Syndesmosis Injury: reliability and prediction of return to function 1998
- Test that gives the best interrater reliability (Syndesmotic ankle sprains in athletes)
Squeeze Test- separation of the tibia and fibula (Evaluation Handbook)
- Identifies a fibular fracture or syndesmosis sprain. Pain will be reproduced along the fibular shaft if it’s a fibular fracture and the distal tibiofibular jt for syndesmosis sprain.
- interrater= 0.5 (moderate) Clinical tests for Ankle Syndesmosis Injury: reliability and prediction of return to function 1998
Cotton Test (Magee)
- Assess for syndesmosis instability with diastasis.
- Performed: steadying the distal leg with one hand while grasping the plantar hell with the opposite hand and moving the heel directly from side to side (Syndesmotic ankle sprain in athletes)
- (+) any lateral translation would indicate syndesmotic instability (Magee)
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