Diagnostic Accuracy of Clinical Tests Assessing Ligamentous Injury of the Talocrural and Subtalar Joints: A Systematic Review With Meta-Analysis

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Fältnamn	Indikatorer	Metadata
000		04330naa a2200433 4500
001		oai:DiVA.org:umu-187365
003		SwePub
008		210910s2022 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1873652 URI
024	7	a https://doi.org/10.1177/194173812110299532 DOI
040		a (SwePub)umu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Netterström-Wedin, Fred H.u Umeå universitet,Institutionen för samhällsmedicin och rehabilitering4 aut
245	1 0	a Diagnostic Accuracy of Clinical Tests Assessing Ligamentous Injury of the Talocrural and Subtalar Joints :b A Systematic Review With Meta-Analysis
264		c 2021-07-21
264	1	b Sage Publications,c 2022
338		a electronic2 rdacarrier
520		a Context: Ankle sprains are the most common acute musculoskeletal injury. Clinical tests represent the first opportunity to assess the sprain's severity, but no systematic review has compared these tests to contemporary reference standards.Objective: To determine the diagnostic accuracy of clinical tests assessing the talocrural and subtalar joint ligaments after ankle sprain.Data Sources: CINAHL, EMBASE, MEDLINE, hand-searching, and PubMed-related article searches (inception to November 18, 2020).Study Selection: Eligible diagnostic studies compared clinical examination (palpation, joint laxity) against imaging or surgery. Studies at a high risk of bias or with high concerns regarding applicability on Quality Assessment of Diagnostic Accuracy Studies-2 were excluded from the meta-analysis.Study Design: Systematic review and meta-analysis.Level of Evidence: Level 3a.Data Extraction: True-positive, false-negative, false-positive, and true-negative findings were extracted to calculate sensitivity, specificity, and likelihood ratios. If ordinal data were reported, these were extracted to calculate Cohen's kappa.Results: A total of 14 studies met the inclusion criteria (6302 observations; 9 clinical tests). No test had both sensitivity and specificity exceeding 90%. Palpation of the anterior talofibular ligament is highly sensitive (sensitivity 95%-100%; specificity 0%-32%; min-max; n = 6) but less so for the calcaneofibular ligament (sensitivity 49%-100%; specificity 26%-79%; min-max; n = 6). Pooled data from 6 studies (885 observations) found a low sensitivity (54%; 95% CI 35%-71%) but high specificity (87%; 95% CI 63%-96%) for the anterior drawer test.Conclusion: The anterior talofibular ligament is best assessed using a cluster of palpation (rule out), and anterior drawer testing (rule in). The talar tilt test can rule in injury to the calcaneofibular ligament, but a sensitive clinical test for the ligament is lacking. It is unclear if ligamentous injury grading can be done beyond the binary (injured vs uninjured), and clinical tests of the subtalar joint ligaments are not well researched. The generalizability of our findings is limited by insufficient reporting on blinding and poor study quality.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Ortopedi0 (SwePub)302112 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Orthopaedics0 (SwePub)302112 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Idrottsvetenskap0 (SwePub)303082 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Sport and Fitness Sciences0 (SwePub)303082 hsv//eng
653		a diagnosis
653		a ankle
653		a examination
653		a ligament
653		a meta-analysis
700	1	a Matthews, M. K.4 aut
700	1	a Bleakley, Chris4 aut
710	2	a Umeå universitetb Institutionen för samhällsmedicin och rehabilitering4 org
773	0	t Sports health: a multidisciplinary approachd : Sage Publicationsg 14:3, s. 336-347q 14:3<336-347x 1941-7381x 1941-0921
856	4	u https://doi.org/10.1177/19417381211029953y Fulltext
856	4	u https://umu.diva-portal.org/smash/get/diva2:1592984/FULLTEXT02.pdfx primaryx Raw objecty fulltext:print
856	4	u https://journals.sagepub.com/doi/pdf/10.1177/19417381211029953
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-187365
856	4 8	u https://doi.org/10.1177/19417381211029953

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Av författaren/redakt...: Netterström-Wedi ...; Matthews, M. K.; Bleakley, Chris

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