Assistant Professor of Orthopedic Surgery, Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Foot Ankle Spec. 2024 Apr;17(2):125-130. doi: 10.1177/19386400211055274. Epub 2021 Nov 2.
The aim of this study was to determine morphological variations and normal parameters of the cross-sectional tibiofibular syndesmotic anatomy.
Configurations of syndesmosis, anterior syndesmotic width (ASW), posterior syndesmotic width (PSW), and overlap distance, defined as the overlap of medial fibula with a drawn line from tip of anterior tubercle of incisura fibularis to the posterior tip, were measured on normal computed tomography (CT) scans of 110 cases. Results: Seventy seven male (70%) and 33 female (30%) (left: 50 and right: 60) were assessed. Mean age of the cases was 33 ± 13 (range: 15-80) years. Three different syndesmotic configurations were crescent (55.5%), rectangular (39.1 %), and semicircle (5.4 %). Overall, mean ASW, PSW, and overlap distance were 2.72, 3.98, and 1.02 mm, respectively. Upper limit of normal ASW in crescent, rectangular, and semicircle was 4.80, 4.85, and 3.89 mm, respectively. The maximum of PSW in crescent, rectangular, and semicircle was 6.25, 6.50, and 4.97 mm, respectively. There was not significant difference between syndesmotic configurations based on age (P = .69) and sex (P = .16).
During interpreting axial CT scan to diagnose syndesmotic injuries, the normal range of parameters according to the different configurations of the tibiofibular syndesmosis should be carefully considered.
Level 4.
本研究旨在确定胫腓联合的矢状面形态学变异和正常参数。
在 110 例正常 CT 扫描中测量了胫腓联合的形态、前胫腓联合宽度（ASW）、后胫腓联合宽度（PSW）和重叠距离（定义为腓骨内侧面与从腓骨切迹前结节尖端到后结节尖端的直线之间的重叠距离）。
共评估了 77 名男性（70%）和 33 名女性（30%）（左侧：50 例，右侧：60 例）。病例的平均年龄为 33 ± 13 岁（范围：15-80 岁）。共有三种不同的胫腓联合形态，分别为新月形（55.5%）、矩形（39.1%）和半圆形（5.4%）。总体而言，平均 ASW、PSW 和重叠距离分别为 2.72、3.98 和 1.02mm。新月形、矩形和半圆形的 ASW 正常上限分别为 4.80、4.85 和 3.89mm。新月形、矩形和半圆形的 PSW 最大值分别为 6.25、6.50 和 4.97mm。根据年龄（P=.69）和性别（P=.16），胫腓联合形态之间无显著差异。
在解读轴向 CT 扫描以诊断胫腓联合损伤时，应根据胫腓联合不同的形态仔细考虑参数的正常范围。
4 级。
