Tonogai Ichiro, Hamada Daisuke, Sairyo Koichi
Associate Professor, Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan.
Professor and Chairman, Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan.
J Foot Ankle Surg. 2017 Nov-Dec;56(6):1147-1150. doi: 10.1053/j.jfas.2017.05.020. Epub 2017 Sep 18.
The morphology of the distal tibiofibular syndesmosis can determine the pathology and mechanism of syndesmotic injury. The present study assessed measurements obtained from computed tomography (CT) images of the normal distal tibiofibular syndesmosis in Japanese subjects. CT scans of 120 right feet with a normal distal tibiofibular syndesmosis obtained from January 2009 to December 2016 were retrospectively assessed at the level 10 mm proximal to the tibial plafond. The incisura fibularis was considered concave when its depth was ≥4 mm and shallow when its depth was <4 mm. The depth of the incisura fibularis, anterior tibiofibular distance (TFD), posterior TFD, and longitudinal/transverse length of the distal fibula were measured. The incisura fibularis was concave in 64.2% of the feet and shallow in 35.8%. The mean anterior TFD was 2.2 ± 0.8 mm (2.4 ± 0.8 mm in males; 2.1 ± 0.8 mm in females; 2.1 ± 0.8 mm for concave; 2.2 ± 0.9 mm for shallow). The mean posterior TFD was 5.9 ± 1.6 mm (6.7 ± 2.1 in males; 5.7 ± 1.3 mm in females; 5.5 ± 1.3 mm for concave; 6.5 ± 1.9 mm for shallow). The mean longitudinal/transverse length of the distal fibula at the level of the syndesmosis was 1.2 mm (1.3 mm in males; 1.2 mm in females; 1.1 mm for concave; 1.3 mm for shallow). The mean posterior TFD was significantly greater than the mean anterior TFD and was also significantly greater in males than in females. Significant differences were found in the body mass index, posterior TFD, and longitudinal/transverse length of the distal fibula according to whether the incisura fibularis was concave or shallow. The present study has provided measurements of the normal tibiofibular syndesmosis in the Japanese population. These data suggest that the morphology of the syndesmosis varies, especially with respect to whether the incisura fibularis is concave or shallow.
胫腓下联合的形态可决定下胫腓联合损伤的病理及机制。本研究评估了从日本受试者正常胫腓下联合的计算机断层扫描（CT）图像中获取的测量数据。对2009年1月至2016年12月期间获得的120例右足胫腓下联合正常的CT扫描图像进行回顾性评估，评估层面为胫骨平台近端10毫米处。当腓骨切迹深度≥4毫米时，认为其为凹形；当深度<4毫米时，认为其为浅形。测量腓骨切迹深度、胫腓前间距（TFD）、胫腓后间距及腓骨远端的纵/横径。64.2%的足腓骨切迹为凹形，35.8%为浅形。平均胫腓前间距为2.2±0.8毫米（男性为2.4±0.8毫米；女性为2.1±0.8毫米；凹形为2.1±0.8毫米；浅形为2.2±0.9毫米）。平均胫腓后间距为5.9±1.6毫米（男性为6.7±2.1毫米；女性为5.7±1.3毫米；凹形为5.5±1.3毫米；浅形为6.5±1.9毫米）。在胫腓联合水平处，腓骨远端的平均纵/横径为1.2毫米（男性为1.3毫米；女性为1.2毫米；凹形为1.1毫米；浅形为1.3毫米）。平均胫腓后间距显著大于平均胫腓前间距，且男性显著大于女性。根据腓骨切迹是凹形还是浅形，在体重指数、胫腓后间距及腓骨远端的纵/横径方面发现了显著差异。本研究提供了日本人群正常胫腓联合的测量数据。这些数据表明，胫腓联合的形态各不相同，尤其是在腓骨切迹是凹形还是浅形方面。
