Abstract
Background: Ankle sprains are the most common injury in ankle joint and rank as the second most frequent injury in sports. Objectives: To compare ultrasonography sensitivity in identifying anterior talofibular ligament (ATFL) tears in patients who came within four days of injury vs those who presented later. Methods: A prospective study was conducted at Al-Kindy Teaching Hospital between October 2022 and April 2023, involving consecutive patients who presented to orthopedic outpatient clinic unit with an inversion-type ankle injury. All patients underwent clinical examination by an orthopedic surgeon, followed by an ultrasound assessment of lateral ankle ligaments using a standard protocol, performed by a qualified radiologist. MRI was used as the reference standard for comparison. The patients were divided into two groups based on the timing of the examination. Early examination, for those presented within the first 4 days after the injury, and delayed examination, including those who presented later. Results: This study recruited 40 individuals with magnetic resonance imaging (MRI) -confirmed ATFL tears with a mean age of 32.3 years. Twenty-five (62.5%) patients presented within four days of the injury, whereas 15 (37.5%) patients did so later. Ultrasound identified 35 ATFL tears at an overall sensitivity of 87.5%. Early ultrasound showed the tear in 21 with a sensitivity of 84%. In 14 of 15 delayed presentation patients, ultrasonography detected the ATFL tear with a sensitivity of 93.3%. Conclusions: Ultrasound is useful in early detection of ATFL tears; however, its efficiency improved even further after 4 days post-injury.
Published Version
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