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Ankle gravity stress view in the seated position: A technical tip.

Jorge Briceño1, Bonnie Chien2, Christopher Miller1

  • 1Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

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Summary

A new seated technique for ankle gravity stress views (GSV) simplifies assessing ankle instability in lateral malleolus fractures. This method offers a more comfortable and efficient alternative to the traditional lateral decubitus position.

Keywords:
Ankle fractureGravity stressGravity stress viewMortiseTechnical tip

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Biomechanics

Background:

  • The ankle gravity stress view (GSV) is crucial for diagnosing ankle instability, particularly in isolated lateral malleolus fractures.
  • Current positioning for GSV, often in the lateral decubitus position, presents challenges including patient discomfort and procedural complexity.
  • The manual external rotation stress test is an alternative but may be less effective than GSV.

Purpose of the Study:

  • To introduce and evaluate a novel, simplified technique for obtaining ankle gravity stress views (GSV) with the patient in a seated position.
  • To provide a safer, more comfortable, and time-efficient alternative to the traditional lateral decubitus positioning for ankle stress radiography.

Main Methods:

  • A seated positioning technique for ankle gravity stress views (GSV) was developed and implemented.
  • The technique involves specific patient seating and X-ray beam angulation to achieve the desired stress on the ankle.
  • Clinical feasibility and safety of the seated GSV were assessed.

Main Results:

  • The seated ankle gravity stress view (GSV) technique was successfully performed in patients with isolated lateral malleolus fractures.
  • The method proved to be simple, safe, and well-tolerated by patients, reducing positioning difficulties.
  • This technique allows for effective elucidation of ankle instability without the drawbacks of the lateral decubitus position.

Conclusions:

  • A seated ankle gravity stress view (GSV) is a practical and advantageous method for evaluating ankle instability.
  • This technique offers significant improvements in patient comfort and procedural efficiency compared to traditional methods.
  • The seated GSV should be considered a valuable tool in the assessment of lateral malleolus fractures.