Comparison Between Cotton Test and Tap Test for the Assessment of Coronal Syndesmotic Instability: A Cadaveric Study
| Autor: | Matthieu Lalevée, Ivan C. Giarola, Victoria Vivtcharenko BS, Fernando S. Martins, Nacime S. Mansur MD, Vicenzo Giordano, Andre Wajnsztejn, Shuyuan Li MD, PhD, Kevin N. Dibbern PhD, John E. Femino MD, Cesar de Cesar Netto MD, PhD |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Foot & Ankle Orthopaedics, Vol 7 (2022) |
| Druh dokumentu: | article |
| ISSN: | 2473-0114 24730114 |
| DOI: | 10.1177/2473011421S00299 |
| Popis: | Category: Ankle; Basic Sciences/Biologics; Sports; Trauma Introduction/Purpose: Diagnosis of subtle instability of the distal tibiofibular syndesmosis is challenging. In surgically treated rotational malleolar fractures, instability is typically assessed with the intraoperative Cotton test. However, this test can be unreliable due to its dynamic nature and uncontrolled distraction force. The Tap test is an alternative test where a cortical tap is advanced through the fibula with a progressive, stable, and unidirectional distraction force. The objective of this cadaveric study was to compare the DTFS widening when using the Cotton and Tap tests as diagnostic tools for coronal plane syndesmotic instability. Methods: Ten below-knee cadaveric specimens were tested in intact non-stressed, intact stressed, injured non-stressed, and injured stressed conditions, with stressed conditions utilizing both Cotton and Tap tests. In injured conditions, the syndesmotic ligamentous complex was sectioned (anterolateral longitudinal approach). Perfect fluoroscopic Mortise images were acquired for all conditions. For the Tap test, a 2.5 drill bit was used to drill a hole through both distal fibular cortices. A blunt-edged 3.5mm cortical tap was advanced toward the tibia. For the Cotton test, a lateral distraction force was applied to the distal fibula with a towel clamp. Two observers measured Tibiofibular Clear Space (TFCS) 1cm proximal to the ankle joint line. Intra and interobserver reliabilities were assessed by Intraclass Correlation Coefficient (ICC). Syndesmotic TFCS values for all conditions were compared by paired Wilcoxon. Diagnostic performance of the Cotton and Tap tests was assessed (a relative increase of TFCS>2mm). P-values |
| Databáze: | Directory of Open Access Journals |
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