Gravity Versus Manual External Rotation Stress View in Evaluating Ankle Stability: A Prospective Study

Thu Ba LeBa, Zbigniew Gugala, Randal P. Morris, Vinod K. Panchbhavi

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Background. The purpose of this prospective study was to determine whether gravity versus manual external rotation stress testing effectively detects widening of the medial clear space in isolated ankle fractures when compared with the uninjured contralateral side. Methods. Manual external rotation stress and gravity stress tests were performed on injured and uninjured ankles of ankle fracture patients in a clinic setting. Medial clear space measurements were recorded and differences between gravity and manual stress views were determined. Results. Twenty consecutive patients with ankle injury were enrolled in the study. When compared with the uninjured side, gravity stress views showed a statistically significant (P =.017) increase in medial clear space widening (1.85 ± 1.07 mm) compared with manual stress view widening (1.35 ± 1.04 mm). Conclusions. This study suggests that gravity stress views are as effective as manual external rotation stress views in detecting medial clear space widening in isolated fibular fractures. Level of Evidence: Diagnostic, Level II: Prospective, comparative trial

Original languageEnglish (US)
Pages (from-to)175-179
Number of pages5
JournalFoot and Ankle Specialist
Issue number3
StatePublished - Jun 3 2015


  • ankle fracture
  • ankle stability stress test
  • radiography
  • supination external rotation injury

ASJC Scopus subject areas

  • Surgery
  • Podiatry
  • Orthopedics and Sports Medicine


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