Clinical Characteristics of Acute Anterior Talofibular Ligament Injury in Children with Negative X-ray Fractures
Abstract
The study aimed to explore the clinical characteristics of anterior talofibular ligament (ATFL) injury in children with negative X-ray fractures using musculoskeletal ultrasound.We analyzed a total of 85 children with low-energy ankle sprains who visited the orthopedic outpatient department of Jinan Children's Hospital from June 2023 to December 2024. All participants underwent X-ray and musculoskeletal ultrasound examinations.Based on the examination results, patients who showed fractures on X-rays and other soft tissue injuries such as ligaments on musculoskeletal ultrasound were further excluded.Finally, after strict screening, the included subjects were determined. Data on clinical examinations, X-rays, and musculoskeletal ultrasound examinations of all participants were collected. The degree of pain was assessed using the VAS pain scale, and the degree of ATFL injury was represented by the Kemmochi ultrasound standard.Finally, statistical analysis was conducted.The coincidence rate between the clinical diagnosis and ultrasound diagnosis of ATFL injury in 85 participants was 94.1%.The coincidence rate of X-ray and musculoskeletal ultrasound in the diagnosis of ankle fractures was 67.1%, and the Kappa value was 0.312. Ultimately, a total of 68 children with ATFL injury showing negative fracture results on X-rays were included, including 41 boys and 27 girls. The median age was 9.02 (95%CI,8.36-9.68), with 26 cases on the left side and 42 cases on the right side. The median injury time was 24 hours (95%CI,24.00-37.27). The median VAS pain score was 4.0 points (4.0,5.0). The most common musculoskeletal ultrasound classification was Kemmochi type V, accounting for 41.2%. In conclusion,ATFL injury is common in children with low-energy ankle sprain (94.1%). Clinical physical examination combined with musculoskeletal ultrasound diagnosis is of great significance. KemmochiⅤ was the most common type of ATFL injury with negative X-ray fractures.
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