Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon; The Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon; Center for Evidence-Based Anatomy, Sport & Orthopedics Research, Beirut, Lebanon.
Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon.
Morphologie. 2022 Dec;106(355):241-251. doi: 10.1016/j.morpho.2021.10.004. Epub 2021 Nov 18.
Though injuries to the distal tibiofibular (DTF) syndesmosis are commonly encountered in orthopedic and trauma settings, its anatomical structures have been poorly researched. The commonly overlooked DTF ligament injuries are known to cause chronic ankle pain, instability and post-traumatic osteoarthritis. Quantitative and morphological evidence synthesis has not been yet conducted. A meta-analysis was conducted to collect data from morphological studies to document more accurate details on the prevalence, size, and insertion sites of its components. The Checklist for Anatomical Reviews and Meta-Analyses (CARMA) was followed. Ten studies met the inclusion criteria with a total of 265 investigated ankles. The analysis demonstrated that the anterior and posterior tibiofibular ligaments along with the interosseous ligament were present in 100% of joints. The inferior transverse tibiofibular and the distal fascicle of the anterior tibiofibular ligament were the least prevalent with frequencies of 96% and 86.5%, respectively. The inferior transverse ligament was recorded as the longest ligament. The widest ligament was found to be the interosseous tibiofibular ligament at its fibular attachment. The thickest of the ligamentous components was the posterior tibiofibular ligament. While more cadaveric research is warranted, these results would help directing future biomechanical investigations and planning new research to further aid in diagnostic and therapeutic approaches to the injuries of the distal tibiofibular syndesmosis.
虽然距下胫腓（DTF）联合的损伤在骨科和创伤科中很常见，但对其解剖结构的研究却很少。众所周知，常被忽视的 DTF 韧带损伤会导致慢性踝关节疼痛、不稳定和创伤后骨关节炎。目前尚未进行定量和形态学证据综合研究。本研究进行了荟萃分析，以收集形态学研究的数据，记录其各组成部分的患病率、大小和插入部位的更准确细节。本研究遵循解剖学综述和荟萃分析清单（CARMA）。符合纳入标准的有 10 项研究，共调查了 265 个踝关节。分析表明，100%的关节存在前、后胫腓骨韧带和骨间韧带。下横胫腓骨和前胫腓骨韧带的远束是最不常见的，频率分别为 96%和 86.5%。下横韧带被记录为最长的韧带。在腓骨附着处，最宽的韧带是骨间胫腓骨韧带。韧带成分中最厚的是后胫腓骨韧带。虽然需要更多的尸体研究，但这些结果将有助于指导未来的生物力学研究，并为进一步辅助诊断和治疗距下胫腓联合损伤的方法提供新的研究。
