Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, Gyeonggi-do, Republic of Korea.
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
J Int Med Res. 2022 May;50(5):3000605221098862. doi: 10.1177/03000605221098862.
To compare the parameters associated with the normal ankle syndesmosis between the hindfoot alignment view (HAV) and anteroposterior (AP) view and determine which view is more accurate for comparing the left and right ankles.
This study involved 61 subjects without syndesmosis injury who had radiographs of both ankles. The tibiofibular clear space (TFCS), tibiofibular overlap (TFO), and medial clear space (MCS) were measured in each view. Intraclass correlation coefficients were used to assess the agreement between the two ankles. Difference ratios for the measured parameters between the ankles were also compared.
The agreement for TFCS showed wide disparity between the two ankles (AP view, 0.576; HAV, 0.858). The highest degree of agreement was seen for TFO (AP view, 0.733; HAV, 0.926). The agreement for MCS was low in both groups. The mean difference ratio for TFCS was also lower in the HAV group (9.9%) than in the AP view group (16.4%); a similar result was observed for TFO (16.4% vs. 25.8%).
For evaluation of the syndesmosis, use of the HAV showed increased accuracy and few measurement errors when comparing the left and right ankles relative to use of the AP view.
比较跟骨正位（HAV）和前后位（AP）两种影像学检查测量下正常踝关节胫腓联合参数的差异，以明确哪种影像学检查方法更适合于对比左右踝关节。
本研究纳入 61 例无胫腓联合损伤的患者，所有患者均行双侧踝关节正侧位 X 线检查。分别在 HAV 和 AP 位测量胫腓骨间隙（TFCS）、胫腓骨重叠（TFO）和内踝间隙（MCS）。采用组内相关系数（ICC）评价两种影像学检查方法的一致性，同时比较左右踝关节同一参数的差值比。
两种影像学检查方法中，TFCS 的一致性较差（AP 位，0.576；HAV 位，0.858），TFO 的一致性最好（AP 位，0.733；HAV 位，0.926）。两种影像学检查方法下 MCS 的一致性均较差。HAV 位下 TFCS 的平均差值比（9.9%）明显小于 AP 位（16.4%），TFO 的差值比也存在类似的差异（16.4% vs. 25.8%）。
与 AP 位相比，HAV 位在评估胫腓联合时可提高左右踝关节对比的准确性，减少测量误差。
