DIAGNOSIS OF LIGAMENT RUPTURE OF THE ANKLE JOINT - PHYSICAL-EXAMINATION, ARTHROGRAPHY, STRESS RADIOGRAPHY AND SONOGRAPHY COMPARED IN 160 PATIENTS AFTER INVERSION TRAUMA

We prospectively enrolled 160 consecutive patients with inversion trau ma of the ankle in a diagnostic protocol that included physical examin ation within 2 days and at 5 days after trauma, arthrography, stress r adiography, and ultrasonography. 135 patients had pathological lateral ligament laxity on the later physical examination or lateral ligament rupture diagnosed on arthrography and they were operated on. 122 of t hese patients had ligament ruptures. At clinical follow-up after a min imum of half a year, all of the patients who were not operated on had stable joints without signs of previous ligament ruptures. Delayed phy sical examination at 5 days after the injury led to the highest overal l sensitivity (96%) and specificity (84%) for the detection of a ligam ent rupture. Additional diagnostic procedures, at a considerable cost, yielded little additional information.