*Department of Orthopedics and Traumatology, Gülhane Training and Research Hospital, Ankara, Turkey.
†Department of Radiology, Gülhane Training and Research Hospital, Ankara, Turkey.
J Am Podiatr Med Assoc. 2024 Jul-Aug;114(4). doi: 10.7547/23-145.
Computed tomography (CT) is superior to plain radiography for evaluating ankle syndesmosis, but anatomical variations can affect the measurements. This study aimed to assess the radiologic parameters of the incisura fibularis and the factors that could affect these parameters.
Lower-extremity CT angiography images were used to evaluate the morphology of the incisura fibularis, anterior and posterior tibiofibular distance, longitudinal and transverse length of the distal fibula, length and depth of the incisura fibularis notch, tibiofibular clear space, tibiofibular overlap, and fibular rotation. Each measured parameter was compared based on sex and body side. Also, the effect of age, height, weight, and body mass index (BMI) on parameters was evaluated.
A total of 123 patients (83 men and 40 women) were included, and 246 ankles were measured. The CT measurements demonstrated excellent intraobserver and interobserver reliability. No statistically significant sex or side differences were found in tibiofibular overlap (TFO) and tibiofibular clear space, the most-used parameters in radiographs. Age, weight, and BMI were found to be correlated with TFO.
The present study provides CT measurements of the normal tibiofibular syndesmosis in the Turkish population. Also, the correlations of the parameters with age, height, weight, and BMI are presented. Therefore, TFO and tibiofibular clear space of the uninjured side can be used to plan the treatment of ankle injuries.
计算机断层扫描（CT）在评估踝关节联合部方面优于普通 X 光片，但解剖结构的差异会影响测量结果。本研究旨在评估腓骨切迹的影像学参数及其可能影响这些参数的因素。
使用下肢 CT 血管造影图像评估腓骨切迹的形态、胫腓前距、胫腓后距、腓骨远端的长度和横径、腓骨切迹的长度和深度、胫腓间隙、胫腓重叠、以及腓骨旋转。根据性别和身体侧别比较每个测量参数。同时，评估年龄、身高、体重和体重指数（BMI）对参数的影响。
共纳入 123 例患者（83 名男性和 40 名女性），共测量了 246 个踝关节。CT 测量结果显示观察者内和观察者间的可靠性均良好。在最常用于 X 光片的胫腓重叠（TFO）和胫腓间隙参数方面，未发现性别或侧别差异具有统计学意义。年龄、体重和 BMI 与 TFO 相关。
本研究提供了土耳其人群正常胫腓联合的 CT 测量值，并介绍了参数与年龄、身高、体重和 BMI 的相关性。因此，未受伤侧的 TFO 和胫腓间隙可用于计划踝关节损伤的治疗。
