Clinical tests for ankle syndesmosis injury: reliability and prediction of return to function

The Journal of Orthopaedic and Sports Physical Therapy
A AlonsoR Adams

Abstract

Despite the severity of ankle syndesmosis injuries, it has been argued that they are relatively poorly detected. This study investigated the interrater reliability of four orthopaedic tests for ankle syndesmosis injury and assessed their ability to predict the extended recovery times that have been reported as a consequence of this injury. Nine physiotherapists, working in random pairings, examined 53 subjects, all receiving treatment for ankle injury at two private clinics. Each subject was tested by two physiotherapists who independently performed the palpation test, external rotation test, squeeze test, and dorsiflexion-compression test. Kappa coefficient testing indicated that the external rotation test had the best interrater reliability (kappa = 0.75). The squeeze test was found to have moderate reliability (kappa = 0.50), and the palpation and dorsiflexion-compression tests both had only fair reliability (kappa = 0.36). The degree of pair-wise association between the results of the four tests was low (phi < or = 0.30 for all test combinations), suggesting that if all four tests were performed on the same subject, it was not likely that they would achieve similar results. Follow-up interviews were conducted to determine t...Continue Reading

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