Anthropometric and Clinical Analyses of the Distal Tibia, Posterior Tibial Tendon, and Flexor Digitorum Longus Tendon on MRI.

OBJECTIVE

To determine the gender and age differences in posterior tibial tendon (PTT), flexor digitorum longus tendon (FDLT), medial malleolar groove (MMG), and posterior, anterior, and total posterior malleolus (PMP, APM, and TPM, respectively) and evaluate the use of these parameters for posterior malleolus plating.

STUDY DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

Department of Radiology, Etimesgut Şehit Sait Ertürk State Hospital, Ankara, Turkey, from January to December 2020.

METHODOLOGY

The magnetic resonance images (MRI) of the ankle were evaluated. PTT and FDLT thickness and width, MMG depth, width, length, and groove opening angle, and APM, TPM, and PPM length were measured. Receiver operating characteristic analysis was conducted to determine whether the variables differed between gender and age.

RESULTS

The study included 103 patients (61 women, 42 men). For gender discrimination, the sensitivity, specificity, and cut-off values were 78.6%, 72.1%, and 7.48 mm, respectively. For the PTT width: 76.2%, 77%, and 3.88 mm, respectively; for the PTT thickness: 85.7%, 86.9%, and 40.41 mm, respectively; and for the APM length, the APM, TPM, and PPM length measurements were statistically and significantly differed between the genders (p<0.001). The APM/PPM ratio was 0.47±0.057 mm in women and 0.47±0.060 mm in men, and TPM/PPM was determined as 0.55±0.604 mm and 0.56±0.657 mm. There was a statistically significant weak positive correlation among the age, MMG length, and FDLT width.

CONCLUSION

The groove depth and width, PTT and FDLT width and thickness, and TPM, PPM, and APM length can be used in gender prediction. The APM/PPM ratio can be calculated to determine the plating length in posterior malleolus fractures.

KEY WORDS

Medial malleolar groove, Posterior tibial tendon, Flexor digitorum longus tendon, posterior malleolus, MRI.