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Master Thesis

Validité du test du levier dans le diagnostic clinique de rupture du ligament croisé antérieur du genou

Abstract : INTRODUCTION: The clinical diagnosis of ACL rupture of the knee is based on three tests: the anterior drawer test, the pivot shift test and the Lachman test. The latter is the most commonly used test in mountain medicine. The lever sign test is a new clinical test, first studied by Dr. Lelli in 2014. The main objective of our study was to determine the sensitivity of the lever sign test in the clinical diagnosis of ACL rupture in primary care during an acute knee trauma. The secondary objective was twofold: to calculate the PPV of the lever sign test, and to calculate the sensitivity and PPV of the Lachman test. MATERIALS AND METHODS: This prospective cohort study included patients suffering from an acute knee trauma in French ski resorts between December 1, 2019 and March 15, 2020. The Lachman test and the lever sign test were performed, then compared to MRI results. RESULTS: The study included 258 patients. The sensitivity of the lever sign test was calculated at 61.2% and the PPV at 83.8%. The sensitivity of the Lachman test was calculated at 99.1% and the PPV at 86.5%. CONCLUSION: This study fulfilled its aim to determine the sensitivity of the lever sign test in the clinical diagnosis of ACL rupture and in the clinical setting of the mountain doctors. This sensitivity is lower than expected. As for the Lachman test, it presented a very high sensitivity. It remains the test of choice for the clinical diagnosis of ACL rupture among knee trauma patients. The lever sign test can therefore complement the Lachman test, but is not a substitute for it.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03187974
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Submitted on : Thursday, April 1, 2021 - 3:30:24 PM
Last modification on : Saturday, April 3, 2021 - 3:17:30 AM

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Camille Bucher. Validité du test du levier dans le diagnostic clinique de rupture du ligament croisé antérieur du genou. Médecine humaine et pathologie. 2021. ⟨dumas-03187974⟩

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