Varus talar tilt combined with an internal rotation pivot stress assesses the supination instability vector in lateral ankle ligaments’ injury — cadaver study

Francisco Guerra-Pinto, Nuno Côrte-Real, Tiago Mota Gomes, José Guimarães Consciência, Mark Glazebrook, Xavier Martin Oliva

Research output: Contribution to journalArticle

Abstract

Background: The lack of consensus on the relevance of the varus talar tilt test (VTTT) might be due to the divergence between the insufficiency vector of lateral ankle instability and the direction of this clinical test. Our hypothesis is that the VTTT is more accurate to diagnose lateral ankle ligaments rupture when it's applied with a pre-positioning of the foot in internal rotation (IR). Methods: We compared, in 12 cadaver ankles, the varus opening during a classic VTTT with the same test starting in an IR pivot, using a new arthrometer. Results: The classic VTTT caused a 13° tilt after ATFL section and 23,8° after ATFL and CFL section. The application of a VTTT with an IR prepositioning caused a 21,2° tilt after ATFL section (p = 0,002) and 29,5° after ATFL and CFL section (p = 0,006). Conclusion: The VTTT is better to identify lateral ankle ligaments' insufficiency when it's applied with a pre-positioning of the foot in internal rotation. The resulting vector is similar to the supination trauma.

Original languageEnglish
JournalFoot and Ankle Surgery
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Supination
Ankle Injuries
Cadaver
Ankle Lateral Ligament
Ankle
Foot
Rupture
Wounds and Injuries

Keywords

  • (MeSH terms) Ankle sprains
  • Ankle lateral ligament
  • Anterior talofibular ligament
  • Calcaneofibular ligament
  • Instability
  • Stress test

Cite this

@article{54545da74bd240b4a88f5204520e10ce,
title = "Varus talar tilt combined with an internal rotation pivot stress assesses the supination instability vector in lateral ankle ligaments’ injury — cadaver study",
abstract = "Background: The lack of consensus on the relevance of the varus talar tilt test (VTTT) might be due to the divergence between the insufficiency vector of lateral ankle instability and the direction of this clinical test. Our hypothesis is that the VTTT is more accurate to diagnose lateral ankle ligaments rupture when it's applied with a pre-positioning of the foot in internal rotation (IR). Methods: We compared, in 12 cadaver ankles, the varus opening during a classic VTTT with the same test starting in an IR pivot, using a new arthrometer. Results: The classic VTTT caused a 13° tilt after ATFL section and 23,8° after ATFL and CFL section. The application of a VTTT with an IR prepositioning caused a 21,2° tilt after ATFL section (p = 0,002) and 29,5° after ATFL and CFL section (p = 0,006). Conclusion: The VTTT is better to identify lateral ankle ligaments' insufficiency when it's applied with a pre-positioning of the foot in internal rotation. The resulting vector is similar to the supination trauma.",
keywords = "(MeSH terms) Ankle sprains, Ankle lateral ligament, Anterior talofibular ligament, Calcaneofibular ligament, Instability, Stress test",
author = "Francisco Guerra-Pinto and Nuno C{\^o}rte-Real and Gomes, {Tiago Mota} and Consci{\^e}ncia, {Jos{\'e} Guimar{\~a}es} and Mark Glazebrook and Oliva, {Xavier Martin}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.fas.2019.03.007",
language = "English",
journal = "Foot and Ankle Surgery",
issn = "1268-7731",
publisher = "Wiley",

}

TY - JOUR

T1 - Varus talar tilt combined with an internal rotation pivot stress assesses the supination instability vector in lateral ankle ligaments’ injury — cadaver study

AU - Guerra-Pinto, Francisco

AU - Côrte-Real, Nuno

AU - Gomes, Tiago Mota

AU - Consciência, José Guimarães

AU - Glazebrook, Mark

AU - Oliva, Xavier Martin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The lack of consensus on the relevance of the varus talar tilt test (VTTT) might be due to the divergence between the insufficiency vector of lateral ankle instability and the direction of this clinical test. Our hypothesis is that the VTTT is more accurate to diagnose lateral ankle ligaments rupture when it's applied with a pre-positioning of the foot in internal rotation (IR). Methods: We compared, in 12 cadaver ankles, the varus opening during a classic VTTT with the same test starting in an IR pivot, using a new arthrometer. Results: The classic VTTT caused a 13° tilt after ATFL section and 23,8° after ATFL and CFL section. The application of a VTTT with an IR prepositioning caused a 21,2° tilt after ATFL section (p = 0,002) and 29,5° after ATFL and CFL section (p = 0,006). Conclusion: The VTTT is better to identify lateral ankle ligaments' insufficiency when it's applied with a pre-positioning of the foot in internal rotation. The resulting vector is similar to the supination trauma.

AB - Background: The lack of consensus on the relevance of the varus talar tilt test (VTTT) might be due to the divergence between the insufficiency vector of lateral ankle instability and the direction of this clinical test. Our hypothesis is that the VTTT is more accurate to diagnose lateral ankle ligaments rupture when it's applied with a pre-positioning of the foot in internal rotation (IR). Methods: We compared, in 12 cadaver ankles, the varus opening during a classic VTTT with the same test starting in an IR pivot, using a new arthrometer. Results: The classic VTTT caused a 13° tilt after ATFL section and 23,8° after ATFL and CFL section. The application of a VTTT with an IR prepositioning caused a 21,2° tilt after ATFL section (p = 0,002) and 29,5° after ATFL and CFL section (p = 0,006). Conclusion: The VTTT is better to identify lateral ankle ligaments' insufficiency when it's applied with a pre-positioning of the foot in internal rotation. The resulting vector is similar to the supination trauma.

KW - (MeSH terms) Ankle sprains

KW - Ankle lateral ligament

KW - Anterior talofibular ligament

KW - Calcaneofibular ligament

KW - Instability

KW - Stress test

UR - http://www.scopus.com/inward/record.url?scp=85064139732&partnerID=8YFLogxK

U2 - 10.1016/j.fas.2019.03.007

DO - 10.1016/j.fas.2019.03.007

M3 - Article

JO - Foot and Ankle Surgery

JF - Foot and Ankle Surgery

SN - 1268-7731

ER -