Kim Jahyung, Park Jeong-Hyun, Kwon Hyung-Wook, Lee Mijeong, Kim Digud, Choi Yu-Jin, Park Kwang-Rak, Lee Sookyoung, Cho Jaeho
Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju 11428, Republic of Korea.
Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea.
Diagnostics (Basel). 2023 Dec 24;14(1):36. doi: 10.3390/diagnostics14010036.
Distal tibiofibular syndesmotic injuries, often misdiagnosed, can lead to substantial morbidity. This study utilized postmortem computed tomography (PMCT) to define normal syndesmotic relationships in 131 subjects.
Three parameters were measured: fibular rotation (FR), sagittal translation (ST), and incisura depth (ID).
Interobserver reliability was excellent for FR and ID but moderate for ST. Anatomical variability was wide, with FR ranging from -0.4° to 16.6°, ST from 0.33 mm to 3.49 mm, and ID from 1.89 mm to 6.05 mm. Side-to-side variability within subjects was minimal. Gender-specific differences were observed in ST, possibly due to size variations, highlighting the need for gender-specific diagnostic criteria.
Although establishing universal reference values is challenging, using contralateral ankles for comparison can enhance diagnostic accuracy in syndesmotic injuries. This study, the first of its kind, offers valuable insights into normal distal tibiofibular syndesmotic relationships based on PMCT data. Future validation studies in patients with syndesmotic injuries can further improve diagnostic accuracy.
胫腓下联合损伤常被误诊，可导致严重的发病情况。本研究利用尸体计算机断层扫描（PMCT）来确定131名受试者的正常联合关系。
测量了三个参数：腓骨旋转（FR）、矢状面平移（ST）和切迹深度（ID）。
观察者间对FR和ID的可靠性极佳，但对ST的可靠性为中等。解剖变异范围广泛，FR为-0.4°至16.6°，ST为0.33毫米至3.49毫米，ID为1.89毫米至6.05毫米。受试者双侧间的变异最小。在ST方面观察到了性别差异，可能是由于体型差异所致，这凸显了制定针对性别诊断标准的必要性。
虽然建立通用参考值具有挑战性，但使用对侧踝关节进行比较可提高联合损伤的诊断准确性。本研究为首创，基于PMCT数据为正常胫腓下联合关系提供了有价值的见解。未来对联合损伤患者的验证研究可进一步提高诊断准确性。
