[Standardized ultrasound diagnosis of instability after dislocation of the upper ankle joint]

The anterior drawer was evaluated sonographically under standard conditions (150 N load, 7.5 MHz linear scanner) in 95 patients with severe ankle sprain. A simple geometric construct of subsidiary lines set up with the help of a goniometer on the videoprints (enlargement 1.5 X) enabled a standardized interpretation of the anterior drawer (pathologic > or = 3 mm). Thus, the definition of poorly reproducible reference points for sonographic measurements became avoidable. In 60 patients a rupture of the lateral ankle ligaments was diagnosed, in 35 patients the findings were recorded as severe ankle sprains without ligament rupture. Compared with the radiological anterior drawer and talar tilt, the dynamic sonographic measurement of the anterior drawer showed the better values from the aspects of sensitivity, specificity and accuracy (> or = 0.93). In our own practice sonographic measurement of anterior drawer has replaced stress radiograms in diagnosis of ankle joint instabilities after severe ankle sprains.