J Korean Foot Ankle Soc.  2011 Mar;15(1):22-26.

Evaluation of Intraoperative Stress Radiologic Tests for Syndesmotic Injuries

• Bae SY
• Chung HJ
• Oh SC

Abstract

PURPOSE
To report the effectiveness of adding distal fibular external rotation stress test on the traditional lateral stress Cotton test in evaluating distal tibiofibular syndesmotic injuries.
MATERIALS AND METHODS
We evaluated syndesmotic injuries with intraoperative stress test during treating ankle fractures from March 2009 to September 2010. External rotation of distal fibula using small elevator was added on traditional stress test in case of suspicious syndesmotic injury. We retrospectively reviewed and compared the results of each test in 44 cases for which we tried both tests.
RESULTS
In 9 cases of positive traditional lateral stress tests, positive results were obtained in all cases by additional external rotation tests. In 21 cases of negative traditional stress tests, additional stress tests results were also negative. But there were 10 cases of positive additional tests and 4 of negative additional tests in equivocal results cases by the traditional stress tests.
CONCLUSION
Using additional external rotation stress test in case of equivocal test result by the traditional lateral stress Cotton test for evaluation of syndesmotic injury during operation for ankle fracture can be a supplemental method to clarify syndesmotic injury needs fixation.

Keyword

Ankle fracture; Syndesmotic injury; Intraoperative stress test

MeSH Terms

Animals
Ankle
Elevators and Escalators
Exercise Test
Fibula
Retrospective Studies