POSTER ABSTRACTS - ISAKOS

Stress fractures were not affected by height,
weight, BMI or the arch of the foot. Irregular
menstruation (p=0.17, and for dangerous SF,
p=0.05) and an older age of menarche (p=0.14)
showed a tendency for a higher occurrence of
stress fractures. A mild tendency for less
dangerous stress fracture was shown in higher use
of milk products (p=0.25) and birth control pills
showed a mild tendency for stress fracture
reduction (p=0.24).
Scoliosis seemed to cause dangerous stress
fracture (p=0.06) and a valgus heel showed a
possible mild tendency for the same (p=0.09-0.22)
as more so did ankle instability (p=0.03-0.15).
(The 2 numbers represented right and left).
Conclusions:
Amenorrhea, late menarche and possibly irregular
menstruation, unstable ankles and heel valgus
seem to be related to stress fractures in female
infantry recruits, especially the dangerous
fractures, occurring in the shaft of the long bones.
The footprint, hip rotation, height, weight and BMI
were not shown to effect stress fracture
occurrence.
In our study of female Infantry recruits 20% to 30%
suffered LBP, AKP and acute ankle sprains.
Further research should probably be directed to
reduction of this unacceptable high rate.
E-poster w/ Standard #129
Diagnostic Value of Stress X-P, Ultrasound, and
MR imaging for Disruption of the Anterior
Talofibular Ligament.
Kazunori Oae, Izumo, Shimane JAPAN, Presenter
Masato Takao, Izumo, Shimane JAPAN
Yuji Uchio, Izumo, Shimane JAPAN
Kohei Naito, Ohdashi, Shimane JAPAN
Jun Ishida, Izumo, Shimane JAPAN
Hideaki Nishi, Izumo Shimane JAPAN
Nobuo Yamagami Izumo Shimane JAPAN
Mitsuo Ochi Hiroshima Hiroshima JAPAN
Shimane University School of Medicine, Izumo,
Shimane, JAPAN
Purpose: To evaluate the diagnostic value of
Stress X-P, Ultrasound (US), and magnetic
resonance (MR) imaging in comparison with that
of arthroscopic findings for injuries of the anterior
talofibular ligament (ATFL).
Materials and Methods: This study involved
twenty-nine patients with ankle sprain. There were
16 acute ankle injuries and 13 chronic ankle
injuries. Preoperative stress X-P, US, and MR
imaging to diagnose the ATFL disruption and
identify its location were compared with the
arthroscopic findings. Bilateral ankle stress X-P
was performed. If there was 5 degree or greater
difference in inversion stress compared with
contralateral side, we regarded the case as
showing lateral instability of the ankle. After that,
US and MR imaging was performed in all patients.
The diagnostic criteria by US were 1)
discontinuity, 2) hyper-echoic lesion. The
diagnostic criteria by MR imaging were 1)
discontinuity, 2) a wavy or curved contour, and 3)
increased signal intensity within the ligament. The
arthroscopic results were considered to be the
gold standard, and the stress X-P, US, and MR
imaging results were compared to the
arthroscopic results.
Results: Arthroscopic findings showed ATFL
disruption in 25 out of 29 cases. Their disruption
located at the attachment of the fibula (n=10), the
mid-substance (n=6), and the attachment of the
talus (n=9) under arthroscopy. The diagnosis of
ATFL disruption with stress X-P was made with an
accuracy of 59% (acute: 44%, chronic: 77%). The
diagnosis of ATFL disruption with US was made
with an accuracy of 90%. The diagnosis of ATFL
disruption with MR imaging was made with an
accuracy of 97%.
US demonstrated the same location of the
disruption as arthroscopy in 16 cases out of 25.
MR imaging demonstrated the same location of
the disruption as arthroscopy in 23 cases out of
25.
Conclusion: The stress X-P can demonstrate the
degree of laxity in the ankle joint. However, the
stress X-P is difficult to perform for acute ankle
sprains because of patient pain, edema and
muscle spasms. Therefore, it is not suitable for
the acute ankle injuries. US is a simple method of
exploring ligament injury. We obtained a
satisfactory result for the diagnosis of the
ligament injury. However, it can not detect the
location of the ligament disruption. Relatively, the
MR imaging is able to detect the location of the
ligament disruption. It is a useful tool for
clarifying the location of the ligament tear
preoperatively.