CME OnDemand: 2022 AOFAS Annual Meeting-High Reproducibility of a Novel Fixed Anterior Drawer Test for Diagnosing Ankle Instability

High Reproducibility of a Novel Fixed Anterior Drawer Test for Diagnosing Ankle Instability

Pdf Summary

The study aimed to evaluate a novel modified anterior drawer test (ADT) for diagnosing ankle instability and compare its reproducibility and accuracy to traditional ADTs. The traditional ADT is convenient and cost-free but lacks reproducibility, particularly among less experienced clinicians. The study included 30 ankles (24 patients) with or without a history of ankle sprain. Evaluations were done using stress radiography and manual ADT, both performed by a junior resident and a senior orthopedic surgeon. The results showed that the sensitivity of the modified ADT was higher than that of the traditional ADT when performed by the junior examiner. Additionally, the distance of anterior displacement measured by the junior examiner was significantly lower in the traditional ADT compared to the senior examiner. However, the correlation coefficient of anterior drawer displacement between examiners was highly significant in the modified ADT. The discussion highlighted that traditional ADT requires skilled technique and subtle sensations, while the modified ADT is preferred for less experienced examiners as it reduces hand movements and muscle spasms. In conclusion, the study demonstrated the reproducibility and accuracy of ADTs using a capacitance-type sensor device, and the modified ADT had higher inter-rater reliability than the traditional procedure. The modified ADT may be useful for evaluating ankle instability with less error between examiners.

Asset Subtitle

Yasutaka Murahashi, Atsushi Teramoto, MD, Katsunori Takahashi, Kota Watanabe, Toshihiko Yamashita

Keywords

novel modified anterior drawer test

ankle instability

reproducibility

accuracy

traditional ADTs

less experienced clinicians

stress radiography

sensitivity

anterior displacement

inter-rater reliability