[Original Article]Inter-examiner variability in three-dimensional kinematics of manual ankle anterior drawer test

[ABSTRACT]【Purpose】To clarify three-dimensional ankle kinematics during manual anterior drawer test in cadaveric anterior talofibular ligament (ATFL) injury models. 【Methods】A total of eight certified orthopedic surgeons performed anterior drawer tests on intact and ATFL-resected cadaveric ankles in a blind fashion. Three-dimensional ankle kinematics, including the ATFL length change, talar anterior translation, and talar internal rotation, were measured during the test using infrared markers mounted on the tibia and talus. An independent certified orthopaedic surgeon visually evaluated the examiner’s technique. Furthermore, the examiners also assessed ankle instability. The kinematic variables between the intact and ATFL-resected ankles were compared using Wilcoxon signed-rank tests. 【Results】The median (25th, 75th percentiles) ATFL length change during the maneuver was 3.1 (2.4, 6.8) mm in the intact and 6.2 (4.2, 7.3) mm in the ATFL-resected ankles, with no significant difference (P = 0.31). Moreover, three of eight examiners had smaller length changes in the ATFL-resected ankles than in the intact ankles. There were no significant differences in talar anterior translation or internal rotation between the ligament conditions. Five of the eight examiners assessed the intact ankle incorrectly as unstable, and two examiners assessed the ATFL-resected ankle incorrectly as stable. 【Conclusion】Ankle kinematics and examination techniques of manual anterior drawer tests varied greatly among certified orthopaedic surgeons. Moreover, the examiner’s assessments of instability were inconsistent. This study highlighted the difficulty of the anterior drawer test and the need for further research to improve the technique and diagnostic accuracy.

https://opac.ll.chiba-u.jp/da/curator/900122662/

https://opac.ll.chiba-u.jp/da/curator/900122662/S03035476-100E-4-P49.pdf

The Chiba Medical Society

千葉医学会

学術雑誌論文

AN00142148

Chiba medical journal

100E

4

49

56

2024-09-10

10.20776/S03035476-100E-4-P49

publisher

Chiba Medical Journal (ONLINE ISSN 2433-4235)