Normal tibiofibular relationships at the syndesmosis on axial CT imaging

Gregory D. Dikos, Jason Heisler, Robert Choplin, Timothy G. Weber

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Objectives: Computed tomography (CT) is reported to be superior to plain radiography for imaging the syndesmosis, but CT criteria differentiating normal from abnormal tibiofibular relationships do not exist. The purpose of this study was to define normal tibiofibular relationships at the syndesmosis on axial CT imaging and to report the reliability of these measurements. Methods: Thirty healthy volunteers underwent CT evaluation of bilateral ankles. Axial CT measurements consisted of tibiofibular clear space, tibiofibular overlap, anterior tibiofibular interval, and fibular rotation (θfib). To assess reliability, 3 investigators independently made each CT measurement on 2 separate occasions. Results: Sixty ankles were included for analysis. CT measurements demonstrated excellent intrarater and interrater reliability. There was significant anatomic variability between individuals. Specifically, statistically significant gender differences were discovered in CT measurements of tibiofibular overlap and anterior tibiofibular interval. Variance between ankles of each subject was calculated. In an uninjured population, tibiofibular intervals do not vary by more than 2.3 mm, and the rotation of the fibula does not vary by more than 6.5° between ankles of the same person. Conclusions: Measurements of tibiofibular relationships made on axial CT images are reliable. Because of significant anatomic variation between individuals, using a patient's contralateral ankle for comparison provides a precise definition of normal tibiofibular relationships. These criteria allow for the detection of subtle variations in the tibiofibular relationships indicating instability and provide a tool for postoperatively assessing the reduction of the injured syndesmosis.

Original languageEnglish
Pages (from-to)433-438
Number of pages6
JournalJournal of Orthopaedic Trauma
Volume26
Issue number7
DOIs
StatePublished - Jul 2012

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Tomography
Ankle
Anatomic Variation
Fibula
Radiography
Healthy Volunteers
Research Personnel
Population

Keywords

  • computed tomography
  • reliability
  • syndesmosis
  • tibiofibular relationships

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Normal tibiofibular relationships at the syndesmosis on axial CT imaging. / Dikos, Gregory D.; Heisler, Jason; Choplin, Robert; Weber, Timothy G.

In: Journal of Orthopaedic Trauma, Vol. 26, No. 7, 07.2012, p. 433-438.

Research output: Contribution to journalArticle

Dikos, Gregory D. ; Heisler, Jason ; Choplin, Robert ; Weber, Timothy G. / Normal tibiofibular relationships at the syndesmosis on axial CT imaging. In: Journal of Orthopaedic Trauma. 2012 ; Vol. 26, No. 7. pp. 433-438.
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