Orthopaedic Center of People's Liberation Army, the Affiliated Southeast Hospital of Xiamen University, Zhangzhou, China.
Experimental Surgery and Regenerative Medicine, Department of Surgery, Ludwig-Maximilians-University (LMU), Munich, Germany.
Sci Rep. 2017 Jul 24;7(1):6244. doi: 10.1038/s41598-017-06602-4.
Distal tibiofibular syndesmosis (DTS) has wide anatomic variability in depth of incisura fibularis and shape of tibial tubercles. We designed a 3-year prospective cohort study of 300 young physical training soldiers in an Army Physical Fitness School. Ankle computed tomography (CT) scans showed that 56% of the incisura fibularis were a "C" shape, 25% were a "1" shape, and 19% were a "Г" shape. Furthermore, we invited a randomly selected subcohort of 6 participants in each shape of DTS to undergo a three-dimensional (3D) laser scanning. The "1" shape group showed widest displacement range of the DTS in the y-axis, along with the range of motion (ROM) on the position more than 20° of the ankle dorsiflexion, inversion and eversion. During the 3-year study period, 23 participants experienced recurrent lateral ankle sprains. 7 cases of the incisura fibularis were "C" shape, 13 cases were "1" shape, and 3 cases were "Г" shape. The "1" shape showed highest risk among the three shapes in incident recurrent lateral ankle sprains. We propose that it is possible to classify shapes of DTS according to the shapes of incisura fibularis, and people with "1" shape may have more risk of recurrent lateral ankle sprains.
下胫腓联合（DTS）在腓骨切迹深度和胫骨结节形状上具有广泛的解剖学变异性。我们设计了一项为期 3 年的前瞻性队列研究，纳入了 300 名陆军体能训练学校的年轻体能训练士兵。踝关节计算机断层扫描（CT）显示，56%的腓骨切迹呈“C”形，25%呈“1”形，19%呈“Г”形。此外，我们邀请了 DTS 每一种形状的 6 名参与者组成随机亚组进行三维（3D）激光扫描。“1”形组在 y 轴上表现出 DTS 的最大位移范围，以及踝关节背屈、内翻和外翻超过 20°位置的运动范围（ROM）。在 3 年的研究期间，23 名参与者经历了复发性外侧踝关节扭伤。7 例腓骨切迹呈“C”形，13 例呈“1”形，3 例呈“Г”形。在三种形状中，“1”形在复发性外侧踝关节扭伤中风险最高。我们提出，根据腓骨切迹的形状对 DTS 的形状进行分类是可能的，“1”形的人可能有更高的复发性外侧踝关节扭伤风险。
