Injuries of the lateral ankle ligaments: classification with tenography and arthrography

To assess the value of tenography of the peroneal tendon sheaths and of arthrography of the tibiotalar joint for the diagnosis and classification of recent ruptures of the lateral ankle ligaments, the authors performed a prospective study on 108 patients with inversion trauma of the ankle. All patients underwent tenography. Arthrography was performed if results of tenography were negative. All patients with positive tenographic or arthrographic results underwent surgery. Tenography proved to be reliable in the diagnosis of injuries of the calcaneofibular ligament (sensitivity, 88%; specificity, 87%-94%). The positive predictive value of tenography in combination with arthrography was 100% for the diagnosis of lateral ligament ruptures. The authors conclude that a combination of arthrography and tenography is a reliable method for diagnosing recent ruptures of the lateral ankle ligaments and for differentiating between isolated ruptures of the talofibular ligament and combined lesions of both the talofibular and the calcaneofibular ligaments.