Évaluation de la gravité des lésions du ligament collatéral latéral de cheville : étude de corrélation clinique-échographie

Abstract

The clinical examination is sometimes insufficient to assess the severity of lateral collateral ligament (LCL) sprain of the ankle, making it difficult to choose the most appropriate treatment. The purpose of this study was to compare retrospectively the observed or reported clinical signs assessed two days after the trauma and ultrasound findings in patients who experienced a recent ankle inversion trauma. Between 1st May and 1st November 2004, 34 patients referred in the sports medicine service were clinically examined in a standardized way two days after the injury, and underwent an ultrasound by the same operator. No isolated clinical sign was correlated with the severity of ligamentous lesions revealed by ultrasound. Taking in account the whole set of the clinical signs appear to better guide for diagnosing the presence or absence of a ligament rupture: positive predictive value if the presence of all the signs equal to 75% for the anterior talofibular ligament (LTFA) and 88% for fibular ligament (CFL), negative predictive value if all the signs of lack of gravity equal to 80% for LTFA and 62% for the CFL. These results confirm the lack of correlation between clinical signs and Imaging findings in ankle sprains. They raise questions about the adequacy of clinical classifications and suggest an expansion of indications for ultrasound in ambiguous situations, especially for athletes showing little signs of severity, to ensure optimal treatment and faster recovery.