ULTRASOUND AS A DIAGNOSTIC MEASURE IN THE RUPTURE OF FIBULAR LIGAMENTS - A COMPARATIVE-STUDY - ULTRASOUND VERSUS X-RAY

Purpose: The present prospective clinical study was designed to verify the value of ultrasound examination concerning injuries of the fibula r ligaments of the ankle using functional examinations under ultrasoun d supervision. Method: 34 patients who had sustained a lesion of the f ibular ligaments of the ankle were compared with 42 healthy persons. T he lateral malleolus and the collum tall were used as reproducible bon y landmarks in ultrasound. The distance between those two points is fi rst of all was measured in neutral position and later on under the inf luence of supinating force of 15 kp using a Telos(TM) fixation device. Results: The average lateral opening of the upper ankle joint measure d with the dynamic ultrasound examination was 4.4 mm (1 - 12 mm) in th e group of patients who had been suffering from rupture of the fibular ligaments. In comparison the average lateral opening of the healthy c ontralateral ankle was 3.9 mm (1 - 9 mm). The control group showed an average lateral opening of 0.9 mm (0 - 5 mm). Conclusion: Direct ultra sonic visualisation of the fibular ligament is not yet reliable. The d escribed method allows an estimation of the stability of the fibular l igaments even in cases of chronic instability. The ultrasound investig ation method discussed is difficult to handle and for that reason it c annot replace the standardised x-ray examination.