Study | Participants | Inclusion–exclusion criteria | Procedures | Tests investigated | Reference standard used |
---|---|---|---|---|---|
Nussbaum et al16 | N=60 (51M, 9F) NCAA Division I-A athletes with syndesmosis sprain 34 of 60 injuries in football, 9 lacrosse, 8 soccer, 2 rowing and 1 each in wrestling, gymnastics, swimming, track, field hockey, cheerleading, basketball Right ankle 28 Left ankle 32 |
| Physical examination and standard radiographs including AP, internal rotation mortise and lateral views Examined within 24 h of injury by certified athletic trainer. Physician reported on radiographs | Squeeze test Ligament palpation External rotation stress test with passive dorsiflexion | Radiographs |
Beumer et al26 | N=12 3 Participants with suspected chronic syndesmosis injury underwent arthroscopy 9 healthy subjects with asymptomatic ankles | Not defined | Participants sat behind a curtain with exposure only of the lower legs Both legs were examined twice in a different order by 7 examiners (4 orthopaedic surgeons, 3 orthopaedic registrars) Participants did not speak and indicated pain by tapping on a wooden board then pointing to the place where pain was felt Following day, 3 patients with suspected chronic syndesmosis injury underwent arthroscopy | Squeeze test Cotton test Fibula translation External rotation stress test Anterior drawer Dorsiflexion range of motion | Arthroscopy |