Department of Orthopedics, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.
J Orthop Surg (Hong Kong). 2021 Jan-Apr;29(1):2309499020984575. doi: 10.1177/2309499020984575.
This study aimed to use MRI to evaluate the fibula and talus position difference in functional and mechanical ankle stability patients.
61 and 68 patients with functional and mechanical instability, and 60 healthy volunteers were involved. Based on the axial MRI images, the rotation of the talus was identified through the Malleolar Talus Index (MTI). The position relative to the talus (Axial Malleolar Index, AMI) and medial malleolus (Intermalleolar Index, IMI) were used to evaluated the displacement of the fibula.
Post hoc analysis showed that the values of malleolar talus index was significantly larger among mechanical instability (89.18° ± 2.31°) than that in functional instability patients (86.55° ±61.65°, P < 0.001) and healthy volunteers (85.59° ± 2.42°, P < 0.001). The axial malleolar index of the mechanical instability patients (11.39° ± 1.41°) were significantly larger than healthy volunteers (7.91° ± 0.83°) (P < 0.0001). There were no statistically significant differences in the above three indexes between the functional instability patients and healthy volunteers.
The functional instability patients didn't have a posteriorly positioned fibula and an internally rotated talus. The malleolar talus index was significantly larger among mechanical instability patients than that in functional instability patients. Increased malleolar talus index may become a new indirect MRI sign for identifying functional and mechanical instability patients.
本研究旨在使用 MRI 评估功能性和机械性踝关节不稳定患者腓骨和距骨位置差异。
纳入 61 例功能性和 68 例机械性踝关节不稳定患者,以及 60 名健康志愿者。基于轴向 MRI 图像,通过距骨踝突指数(Malleolar Talus Index,MTI)识别距骨的旋转。使用距骨相对位置(轴向踝突指数,Axial Malleolar Index,AMI)和内踝突(踝间指数,Intermalleolar Index,IMI)评估腓骨的位置。
事后分析显示,机械性不稳定患者的踝突距骨指数(89.18°±2.31°)显著大于功能性不稳定患者(86.55°±61.65°,P<0.001)和健康志愿者(85.59°±2.42°,P<0.001)。机械性不稳定患者的轴向踝突指数(11.39°±1.41°)显著大于健康志愿者(7.91°±0.83°)(P<0.0001)。功能性不稳定患者与健康志愿者在上述三个指标上无统计学差异。
功能性不稳定患者的腓骨无后移,距骨无内旋。机械性不稳定患者的踝突距骨指数显著大于功能性不稳定患者。增加的踝突距骨指数可能成为识别功能性和机械性不稳定患者的新的间接 MRI 征象。