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Table 2 Portable ultrasonographic medial clear space measurements during the gravity stress test, weightbearing and the external rotation stress test in the sequentially created SER ankle injury model

From: Ultrasonography for diagnosing medial sided ankle instability in supination external rotation ankle fracture

SER injury

Stage

Loading conditions

Anterior-perpendicular-MCS in mm

(Median, IQR)

Adjusted

P Value

(vs. intact stage)

Inferior-MCS

in mm

(Median, IQR)

Adjusted

P Value

(vs. intact stage)

Anterior-oblique-MCS

in mm

(Median, IQR)

Adjusted

P Value

(vs. intact stage)

Intact

GST-N

3.5

(2.8–4.4)

Ref

3.7

(3.4–3.8)

Ref

6.9

(5.9–7.2)

Ref

GST-PF

4.0

(3.7–4.4)

Ref

4.2

(3.9–4.7)

Ref

8.6

(8.1–9.1)

Ref

Weightbearing

3.0

(1.9–3.4)

Ref

2.7

(2.2–3.2)

Ref

4.9

(4.5–5.8)

Ref

ER stress test

3.7

(3.2–4.6)

Ref

4.3

(3.9–4.5)

Ref

7.1

(6.1–7.5)

Ref

I

GST-N

4.0

(3.4–4.5)

0.11

3.8

(3.7–4.7)

0.33

7.4

(6.2–8.5)

0.24

GST-PF

4.5

(3.5–5.3)

0.24

4.6

(3.5–5.2)

0.24

8.1

(6.8–9.4)

0.96

Weightbearing

3.1

(2.8–3.4)

0.20

2.9

(2.6–4.3)

0.20

5.2

(4.1-6.0)

0.88

ER stress test

4.6

(4.4–5.1)

0.021

6.3

(4.5–6.9)

0.033

7.9

(7.0-9.6)

0.028

II

GST-N

5.4

(4.6–6.7)

0.044

5.8

(5.0-6.4)

0.028

8.7

(7.0-9.7)

0.094

GST-PF

5.7

(5.5-6.0)

0.014

5.8

(4.7–7.3)

0.044

9.9

(9.5–11.1)

0.057

Weightbearing

3.1

(2.4–3.9)

0.34

3.1

(2.7–3.5)

0.23

5.7

(5.5–6.1)

0.42

ER stress test

7.5

(7.3–8.8)

0.020

7.1

(5.5–8.5)

0.020

14.1

(12.2–14.7)

0.020

III

GST-N

6.5

(5.7–6.7)

0.026

6.5

(5.9–7.6)

0.028

9.8

(9.5–10.8)

0.026

GST-PF

6.4

(5.1–7.7)

0.026

6.6

(5.5–7.7)

0.050

10.7

(9.7–11.9)

0.021

Weightbearing

3.4

(2.9-4.0)

0.11

3.5

(2.3–4.2)

0.37

5.5

(5.3–6.2)

0.19

ER stress test

8.4

(7.5–10.0)

0.026

8.4

(7.6–9.8)

0.026

15.7

(13.3–16.2)

0.026

IVa

GST-N

7.4

(6.6–8.3)

0.031

6.5

(5.7–6.3)

0.035

11.3

(10.9–12.5)

0.031

GST-PF

6.6

(6.4–7.4)

0.031

6.9

(6.0-8.7)

0.037

11.4

(10.0-12.4)

0.028

Weightbearing

3.6

(3.1–4.5)

0.18

4.3

(3.2–5.5)

0.056

5.6

(4.3–6.8)

0.89

ER stress test

10.3

(8.3–11.0)

0.031

10.2

(8.3–10.5)

0.031

15.8

(14.9–18.2)

0.031

IVb

GST-N

12.3

(10.5–14.4)

0.036

13.5

(11.5–16.0)

0.036

15.6

(14.3–18.3)

0.036

GST-PF

13.1

(12.1–14.6)

0.036

12.4

(11.3–12.6)

0.036

19.0

(16.5–21.6)

0.036

Weightbearing

4.9

(4.5–5.7)

0.036

5.2

(4.4–5.5)

0.036

7.4

(5.6–8.4)

0.036

ER stress test

12.4

(10.0-16.5)

0.036

12.8

(10.8–15.6)

0.036

20.1

(19.3–22.5)

0.036

  1. Significant adjusted P values are in bold for Wilcoxon signed-rank test with Holm-Bonferroni correction. Stage I = AITFL transection; Stage II = AITFL transection + Weber B fibular fracture; Stage III = AITFL transection + Weber B fibular fracture + PITFL transection; Stage IVa = AITFL transection + Weber B fibular fracture + PITFL transection + superficial deltoid transection; Stage IVb = AITFL transection + Weber B fibular fracture + PITFL transection + superficial deltoid transection + deep deltoid transection
  2. Abbreviations: P-US = portable ultrasound; SER = supination external rotation; GST-N = gravity stress test in neutral ankle position; GST-PF = gravity stress test in ankle plantarflexed position; ER = external rotation, mm = millimeter; IQR = interquartile range; MCS = medial clear space; AITFL = anteroinferior tibiofibular ligament; PITFL = posteroinferior tibiofibular ligament; Ref = reference
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Journal of Orthopaedic Surgery and Research

ISSN: 1749-799X