FREY Alain, PAPON Pierre
Medical Department of INSEP, 75012, PARIS, FRANCE
Title: Prospective study of ankle injury in high level athlete in INSEP: incidence of the lesion of the distal tibio-fibular syndesmosis (DTFS).
Biography
Biography: FREY Alain, PAPON Pierre
Abstract
Purpose of the study:The lesion of DFTS are often unknow during ankle trauma. We wanted to see the incidence of this lesion and to validate the specific clinical signs.
Materiel and method:Between March, 2015 and March, 2016, we included any ankle trauma of our high-level sportsmen. They all benefited from an initial clinical examination diligently of the Ottawa rules and a ultrasound realized in 3 days. If there was a lesion of the AITFL in ultrasound, a MRI and stress radiographies were realized. A protocol of treatment was proposed: functional treatment if distension of AITFL, hiking boots if isolated rupture of AITFL, plaster if rupture of AITFL and lesion of inter osseous membrane without diasthasis, surgery if diasthasis. All were seen again to day 8 with reeducation, day 30 and between 4 and 6 months after their trauma.
Results:126 ankle sprains were analyzed (77 M, 49 F) with 28 lesion of DFTS (22.2 %). On day 8, the sensibility and the specificity of the main clinical signs are respectively: AITFL palpation ( 0.94/0.86), lateral rotation test (0.72/0.97), dorsal flexion compression test (0.72/0.97), squeeze test (0.24/0.97). In ultrasound as in MRI, besides the AITFL, are observed 8 inter-osseous membranes lesions, one PITFL lesion, 2 anterior MCL lesion and 8 TFA lesion. 15 functional treatment, 8 hiking boots and 5 plaster. The return to sport at the same level was made between 3 and 12 weeks according to the gravity.
Conclusion:This ligamentary lesion is frequent and affects several sports. The clinical examination repeated to day 8, coupled with ultrasound, seems to be the best compromise to adapt the management.