Ostrum R F, De Meo P, Subramanian R
Division of Orthopaedics, Ohio State University, Columbus 43210, USA.
Foot Ankle Int. 1995 Mar;16(3):128-31. doi: 10.1177/107110079501600304.
To determine the normal anatomic radiographic land-marks of the ankle syndesmosis, standardized anterior-posterior radiographs of the right ankle were performed on 40 male and 40 female volunteers. The average tibiofibular clear space was 3.8 mm in females, 4.6 mm in males, and 4.2 mm overall. The tibiofibular overlap measured 6.0 mm in females, 9.6 mm in males, and 7.8 mm overall. Due to this variability and the gender differences, we investigated the anatomy of the syndesmosis as ratios of the potentially variable values to fixed landmarks. The ratio of the tibiofibular overlap to the fibular width averaged 54% and the ratio of the tibiofibular clear space to the fibular width averaged 30%, with no statistically significant difference due to gender. Our data show that for 90% prediction intervals, the values are: (1) tibiofibular clear space less than 5.2 mm in women and 6.5 mm in men; (2) tibiofibular overlap of greater than 2.1 mm in females and 5.7 mm in males; (3) tibiofibular overlap:fibular width ratio greater than 24%; (4) tibiofibular clear space:fibular width ratio less than 44%. Additionally, using a linear regression model, a prediction of the tibiofibular overlap can be made when using the distance (in millimeters) from the incisura fibularis to the lateral tibial (LT) border: tibiofibular overlap = 0.862 x lateral tibia - 2.62 (P = .0001). Utilization of these values will help in the determination of posttraumatic disruption of the syndesmosis and postoperative assessment of mortise reduction.
为确定踝关节下胫腓联合的正常解剖放射学标志，对40名男性和40名女性志愿者的右踝关节进行了标准化前后位X线片检查。女性胫腓间隙平均为3.8mm，男性为4.6mm，总体平均为4.2mm。女性胫腓重叠平均为6.0mm，男性为9.6mm，总体平均为7.8mm。由于这种变异性和性别差异，我们将下胫腓联合的解剖结构研究为可变值与固定标志的比值。胫腓重叠与腓骨宽度的比值平均为54%，胫腓间隙与腓骨宽度的比值平均为30%，性别差异无统计学意义。我们的数据显示，对于90%的预测区间，数值如下：（1）女性胫腓间隙小于5.2mm，男性小于6.5mm；（2）女性胫腓重叠大于2.1mm，男性大于5.7mm；（3）胫腓重叠：腓骨宽度比值大于24%；（4）胫腓间隙：腓骨宽度比值小于44%。此外，使用线性回归模型，当使用从腓骨切迹到胫骨外侧（LT）边界的距离（以毫米为单位）时，可以预测胫腓重叠：胫腓重叠 = 0.862×胫骨外侧 - 2.62（P = .0001）。利用这些数值将有助于确定创伤后下胫腓联合的损伤情况以及术后榫眼复位的评估。
