External rotation stress imaging in syndesmotic injuries of the ankle - Comparison of lateral radiography and radiostereometry in a cadaveric model

Research output: Contribution to journalArticle


We compared the value of 7.5 Nm external rotation stress in diagnosing tibiofibular syndesmotic injuries of the ankle on lateral radiographs with radiostereometric analysis (RSA) in 10 cadaveric legs. After sectioning 2 ligaments, RSA showed an increase in posterior translation and external rotation of the fibula. This increase in posterior translation was smaller than the posterior displacement of the fibula on the lateral radiograph, and RSA showed mainly an increase in external rotation of the fibula that can not be measured on conventional radiographs. We conclude that instability of the syndesmosis in cadaveric ankles can be detected with 7.5 Nm external rotation stress RSA, but that external rotation stress lateral radiography is unreliable.


  • A Beumer
  • ER Valstar
  • EH Garling
  • WJ van Leeuwen
  • W Sikma
  • R Niesing
  • Jonas Ranstam
  • BA Swierstra
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Orthopedics
Original languageEnglish
Pages (from-to)201-205
JournalActa Orthopaedica Scandinavica
Issue number2
Publication statusPublished - 2003
Publication categoryResearch