1980 Volume 29 Issue 3 Pages 475-478
An Ankle trauma is frequently encountered in the routine clinicalpractice. In spite of a number of recently published reports, little attention has been directed toward the diagnosis and treatment of this sesion. Significantly, residual complaints of such as pains and motor restriction frequently persist after the treatment. As the ankle joint is stabilized by numerous ligaments, early assessment of the extent of an injury to these ligaments is critical to the method of the treatment and prognosis of the trauma to this area.
From 1976 to the present, we have treated 227 patients with ankle traumas. In 46 out of these patients, 25 cases (16 fresh and 9 protracted cases) were without bone injuries and 21 cases (14 fresh and 7 protracted cases) demonstrated bone injuries. Ankle arthrography was conducted in addition to the standard and stress radiography in order to attain the accurate assessment of the extent of soft tissue injuries.
The arthrographic examinations demonstrated ligament injuries in 36 out of 46 patients (78%), of which 21 were without bone injuries and 15 were with bone injuries. In addition, abnormal arthrographic findings were observed in all protracted cases where complaints of continuous pains persisted.
Of those cases with the radiographic evidences of ligament injuries in the absence of bony traumas, 16 demonstrated injuries to the anterior talofibral ligament, 4 to the anterior talofibral and calcaneo-fibral ligaments, and 1 to the medial ligament. Of those cases with bony traumas, 9 demonstrated injuries to the distal tibrofibral ligament, 1 to the distal tibrofibral and lateral colateral ligaments, 2 to the medial ligament, and 3 to the lateral colateral ligament.
Although ankle arthrography is not regarded as a part of the standard diagnostic procedures for the outpatient clinic, this roentgenographic technique has been proved to be of particular value in the diagnosis of injury to the lateral colateral and distal tibrofibral ligaments where the standard and stress radiography has failed. In addition, ankle arthrography appears to be a safe and effective diagnostic procedure in the clinical assessment of ankle trauma.
