Takao M, Ochi M, Naito K, Iwata A, Kawasaki K, Tobita M, Miyamoto W, Oae K
Department of Orthopaedics, Shimane Medical University, Shimane, Japan.
Arthroscopy. 2001 Oct;17(8):836-43. doi: 10.1016/s0749-8063(01)90007-6.
We have been able to diagnose tibiofibular syndesmosis injury by ankle arthroscopy, and in the present study we compare these results with the results from plain radiographs.
Case series.
Thirty-eight type-B (Weber system) distal fibular fractures in 38 patients were diagnosed to determine whether tibiofibular syndesmosis disruption was present. According to the Lauge-Hansen system, 16 patients had supination-external rotation fractures and 22 had pronation-abduction fractures. Standard non-weight-bearing anteroposterior radiographs and mortise radiographs were evaluated. Furthermore, ankle arthroscopy was performed on all patients.
Tibiofibular syndesmosis disruptions were diagnosed in 16 of the 38 patients (42%) by anteroposterior radiography, 21 of 38 patients (55%) by mortise radiography, and 33 of 38 patients (87%) by ankle arthroscopy. All of the patients who were diagnosed with tibiofibular syndesmosis disruption by anteroposterior radiography and mortise radiography were also confirmed by ankle arthroscopy to have injured their tibiofibular syndesmosis. In 12 patients, ankle arthroscopy was the only method used to diagnose the tibiofibular syndesmosis disruption.
Ankle arthroscopy excels in term of the diagnosis ratio for tibiofibular syndesmosis disruption compared with both anteroposterior and mortise radiography. Therefore, we conclude that ankle arthroscopy is necessary for the correct diagnosis of tibiofibular syndesmosis disruption.
我们已经能够通过踝关节镜诊断胫腓下联合损伤，在本研究中，我们将这些结果与X线平片的结果进行比较。
病例系列。
对38例患者的38例B型（Weber分型）腓骨远端骨折进行诊断，以确定是否存在胫腓下联合损伤。根据Lauge-Hansen分型系统，16例患者为旋后-外旋型骨折，22例为旋前-外展型骨折。评估标准的非负重前后位X线片和斜位X线片。此外，对所有患者进行了踝关节镜检查。
38例患者中，通过前后位X线片诊断出胫腓下联合损伤的有16例（42%），通过斜位X线片诊断出的有21例（55%），通过踝关节镜诊断出的有33例（87%）。所有通过前后位X线片和斜位X线片诊断为胫腓下联合损伤的患者，踝关节镜检查也证实其胫腓下联合受伤。在12例患者中，踝关节镜是诊断胫腓下联合损伤的唯一方法。
与前后位X线片和斜位X线片相比，踝关节镜在诊断胫腓下联合损伤的准确率方面更胜一筹。因此，我们得出结论，踝关节镜对于正确诊断胫腓下联合损伤是必要的。
