Boszczyk Andrzej, Kwapisz Sławomir, Krümmel Martin, Grass Rene, Rammelt Stefan
1 Centre of Postgraduate Medical Education, Prof. Adam Gruca Clinical Hospital, Otwock, Poland.
2 Dritter Orden Clinical Hospital Munich-Nymphenburg, Munich, Germany.
Foot Ankle Int. 2018 Mar;39(3):369-375. doi: 10.1177/1071100717744332. Epub 2017 Dec 18.
The anatomy of the syndesmosis is variable, yet little is known on the correlation between differences in anatomy and syndesmosis reduction results. The aim of this study was to analyze the correlation between syndesmotic anatomy and the modes of syndesmotic malreduction.
Bilateral postreduction ankle computed tomography (CT) scans of 72 patients treated for fractures with syndesmotic disruption were analyzed. Incisura depth, fibular engagement into the incisura, and incisura rotation were correlated with degree of syndesmotic malreduction in coronal and sagittal planes as well as rotational malreduction.
Clinically relevant malreduction in the coronal plane, sagittal plane, and rotation affected 8.3%, 27.8%, and 19.4% of syndesmoses, respectively. The syndesmoses with a deep incisura and the fibula not engaged into the tibial incisura were at risk of overcompression, anteverted incisuras at risk of anterior fibular translation, and retroverted incisuras at risk of posterior fibular translation.
Certain morphologic configurations of the tibial incisura increased the risk of specific syndesmotic malreduction patterns.
Level III, comparative study.
下胫腓联合的解剖结构存在变异，但关于解剖差异与下胫腓联合复位结果之间的相关性知之甚少。本研究的目的是分析下胫腓联合解剖结构与下胫腓联合复位不良模式之间的相关性。
对72例因下胫腓联合损伤而接受骨折治疗的患者进行双侧复位后踝关节计算机断层扫描（CT）分析。切迹深度、腓骨嵌入切迹的情况以及切迹旋转与下胫腓联合在冠状面和矢状面的复位不良程度以及旋转复位不良相关。
冠状面、矢状面和旋转方面具有临床相关性的复位不良分别影响了8.3%、27.8%和19.4%的下胫腓联合。切迹较深且腓骨未嵌入胫骨切迹的下胫腓联合有过度压缩的风险，切迹前倾有腓骨向前移位的风险，切迹后倾有腓骨向后移位的风险。
胫骨切迹的某些形态结构增加了特定下胫腓联合复位不良模式的风险。
III级，比较性研究。
