Radiological Evaluation of Distal Tibiofibular Joint Anatomy Variations in Patients with and Without Syndesmotic Injury.

INTRODUCTION

Syndesmosis injuries are a common and debilitating problem affecting the ankle joint, but the precise causes of these injuries remain unclear. In the current retrospective study, it was aimed to investigate the relationship between variations in the distal tibiofibular syndesmosis and surgically proven syndesmosis injuries.

PATIENTS AND METHOD

A total of 57 patients with surgically proven syndesmosis injuries and 51 patients without syndesmosis injuries were included as the control group. Computed tomography (CT) scans were used to measure six anatomical features 1 cm proximal to the tibiotalar joint, including the anterior facet length (a), posterior facet length (b), angle between the anterior and posterior facets (c), fibular incisura depth (d), tibia thickness (e), and fibula thickness (f).

RESULTS

Comparing the measurements of the patients with and without syndesmosis injury, it was demonstrated that the anterior facet length (a) ( = 0.022) was shorter and the a-b difference (anterior facet length-posterior facet length difference) ( = 0.010) tended toward negative values. Pearson correlation analysis demonstrated that a ( = - 0.211,  < 0.033) and a-b ( = - 0.254,  = 0.010) measurements were strongly negatively correlated with syndesmosis injury.

DISCUSSION

Our study findings suggest that the shortness of the anterior facet and the difference in length are related to syndesmosis injuries. To the best of our knowledge, this is the first study to report this relationship with syndesmosis. This study sheds light on the underlying mechanisms of syndesmosis injury, which could help clinicians in the diagnosis, treatment, and prevention of this common ankle injury.: Level 4: case-control study.