scholarly journals Radiographic Evaluation of the Normal Distal Tibiofibular Syndesmosis in Neutral to Dorsiflexion on Weight-Bearing

2021 ◽  
Vol 39 (1) ◽  
pp. 1-9
Author(s):  
Seong Kee Shin ◽  
Ki Chun Kim ◽  
Se Yong Song ◽  
Ki Won Young ◽  
Kyung Tai Lee
Keyword(s):  
Weight Bearing ◽  
Radiographic Evaluation ◽  
Tibiofibular Syndesmosis ◽  
Distal Tibiofibular Syndesmosis

Radiographic Evaluation of the Normal Distal Tibiofibular Syndesmosis

2012 ◽  
Vol 33 (10) ◽  
pp. 870-876 ◽  
Author(s):  
Apurva S. Shah ◽  
Anish R. Kadakia ◽  
Giselle J. Tan ◽  
Mark S. Karadsheh ◽  
Troy D. Wolter ◽  
...  
Keyword(s):  
Radiographic Evaluation ◽  
Tibiofibular Syndesmosis ◽  
Distal Tibiofibular Syndesmosis

Weight-Bearing Radiographic Analysis of the Tibiofibular Syndesmosis

2018 ◽  
Vol 12 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Arsalan Amin ◽  
Cory Janney ◽  
Christopher Sheu ◽  
Daniel C. Jupiter ◽  
Vinod K. Panchbhavi
Keyword(s):  
Weight Bearing ◽  
Intraclass Correlation ◽  
Radiographic Evaluation ◽  
Tibiofibular Syndesmosis ◽  
Female Patients ◽  
Tibial Plafond ◽  
Significant Difference ◽  
Anteroposterior View ◽  
Male Patients ◽  
Orthopaedic Training

Background: Diagnosis of distal tibiofibular syndesmotic injuries includes assessment of radiographs; however, there exist no agreed on standard diagnostic criteria. Previous studies lack consistency with radiographic evaluation methods. The dynamic nature of the ankle joint supports analyzing anatomical parameters using weight-bearing films to assess for tibiofibular syndesmotic integrity. Methods: Weight-bearing tibiofibular syndesmosis radiographs of 39 male and 40 female patients were retrospectively analyzed by 3 investigators, at different levels of orthopaedic training. Measurements 1 cm above the tibial plafond for the anterior tibiofibular overlap (TFO) and tibiofibular clear space (TCS) were recorded and standardized by the fibular width (FW) at 2 time points. Data were compared to check for agreement between the sets of measurements for each rater and agreement between investigators, and to ascertain underlying gender differences. Results: There was good intraobserver correlation (intraclass correlation coefficient [ICC] > 0.90) among investigators for each parameter. A significant difference in the TFO was noted between genders (P < .05). We establish the following radiographic (anteroposterior view) parameters for an intact syndesmosis: male patients, TCS <4.57 mm or TCS/FW <29% and TFO >9.29 mm or TFO/FW > 57%; female patients, TCS <4.28 mm or TCS/FW <30% and TFO >7.41 mm or TFO/FW >51%. Conclusions: Our study provides a more objective approach by utilizing weight-bearing radiographs and performing all measurements 1 cm above the tibial plafond. Levels of Evidence: Level IV

The effects of weight bearing on the distal tibiofibular syndesmosis: A study comparing weight bearing-CT with conventional CT

2019 ◽  
Vol 25 (4) ◽  
pp. 511-516 ◽  
Author(s):  
Karan Malhotra ◽  
Matthew Welck ◽  
Nicholas Cullen ◽  
Dishan Singh ◽  
Andrew J. Goldberg
Keyword(s):  
Weight Bearing ◽  
Tibiofibular Syndesmosis ◽  
Distal Tibiofibular Syndesmosis ◽  
Conventional Ct

A Radiographic Evaluation of the Tibiofibular Syndesmosis

Foot & Ankle ◽  
1989 ◽  
Vol 10 (3) ◽  
pp. 156-160 ◽  
Author(s):  
Marion C. Harper ◽  
Tony S. Keller
Keyword(s):  
Confidence Interval ◽  
Lower Extremities ◽  
Radiographic Evaluation ◽  
Tibiofibular Syndesmosis ◽  
Posterior View ◽  
Clear Space ◽  
Fresh Cadaver ◽  
Reliable Parameter ◽  
Mortise View ◽  
Anterior Posterior

A radiographic evaluation of the normal as well as the progressively widened tibiofibular interval in the area of the syndesmosis was done using 12 fresh cadaver lower extremities. The width of the tibiofibular “clear space” and the amount of tibiofibular overlap was determined on accurately positioned anterior-posterior and mortise radiographs. Based on a 95% confidence interval, measurements obtained for the intact specimens would support the following criteria as consistent with a normal tibio-fibular relationship: (1) a tibiofibular “clear space” on the anterior-posterior and mortise views of less than approximately 6 mm; (2) tibiofibular overlap on the anterior-posterior view of greater than approximately 6 mm or 42% of fibular width; (3) tibiofibular overlap on the mortise view of greater than approximately 1 mm. The width of the tibiofibular “clear space” on both anterior-posterior and mortise views appeared to be the most reliable parameter for detecting early syndesmotic widening.

scholarly journals POSTERIOR TIBIAL TENDON INJURY - IS MISSED DIAGNOSIS, A POSSIBILITY? SHOULD IT BE SUSPECTED IN ALLANKLE EVERSION SPRAINS? - A CASE REPORT

2020 ◽  
pp. 1-2
Author(s):  
Chavda Sumant ◽  
Garg Chaitanya ◽  
George, Biji Thomas ◽  
Jad Allah, Bader
Keyword(s):  
Physical Examination ◽  
Ankle Sprain ◽  
Weight Bearing ◽  
Ankle Injuries ◽  
Radiographic Evaluation ◽  
Tibialis Posterior ◽  
Posterior Tibial Tendon ◽  
Persistent Symptoms ◽  
Posterior Tibial ◽  
Ankle Brace

Ankle sprains are one of the most common injuries that occur among people of all ages and accounts for 75% of ankle injuries and for 10 to 30 percent of sports-related injuries in young athletes. Inversion sprain is more common than eversion ankle sprain, to result in injury to the lateral ligament complex. Though injury to the posterior tibial tendon is not a very common injury associated with eversion ankle sprain, it often can be overlooked and missed in the initial physical examination. We present a case of a college student who sustained a twisting injury to his left ankle while playing football. After initial history, physical examination and plain radiographic evaluation, a diagnosis of eversion ankle sprain was made by a general practitioner and treated conservatively. Due to persistent symptoms and local signs, subsequent evaluation with an MRI study revealed tibialis posterior (TP) tendon strain with diffuse soft tissue swelling extending up to lower third of the leg and associated Grade I osteochondral injury to the posterolateral aspect of talus. The injury was successfully treated with medial arch support ankle brace, analgesics, guarded weight bearing and physiotherapy with full functional recovery in 12 weeks.

A novel method of using elastic bionic fixation device for distal tibiofibular syndesmosis injury

2018 ◽  
Vol 42 (9) ◽  
pp. 2219-2229 ◽  
Author(s):  
Lin Wang ◽  
Yingze Zhang ◽  
Zhaohui Song ◽  
Hengrui Chang ◽  
Ye Tian ◽  
...  
Keyword(s):  
Tibiofibular Syndesmosis ◽  
Fixation Device ◽  
Distal Tibiofibular Syndesmosis ◽  
Syndesmosis Injury ◽  
Novel Method

Impact of Torque on Assessment of Syndesmotic Injuries Using Weightbearing Computed Tomography Scans

2019 ◽  
Vol 40 (6) ◽  
pp. 710-719 ◽  
Author(s):  
Nicola Krähenbühl ◽  
Travis L. Bailey ◽  
Maxwell W. Weinberg ◽  
Nathan P. Davidson ◽  
Beat Hintermann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Axial Load ◽  
External Rotation ◽  
Ct Scans ◽  
Deltoid Ligament ◽  
Tibiofibular Syndesmosis ◽  
Tibiofibular Ligament ◽  
Distal Tibiofibular Syndesmosis ◽  
Axial Ct ◽  
The Impact

Background: The diagnosis of subtle injuries to the distal tibiofibular syndesmosis remains elusive. Conventional radiographs miss a large subset of injuries that present without frank diastasis. This study evaluated the impact of torque application on the assessment of syndesmotic injuries when using weightbearing computed tomography (CT) scans. Methods: Seven pairs of male cadavers (tibia plateau to toe-tip) were included. CT scans with axial load application (85 kg) and with (10 Nm) or without torque to the tibia (corresponding to external rotation of the foot and ankle) were taken during 4 test conditions. First, intact ankles (native) were scanned. Second, 1 specimen from each pair underwent anterior inferior tibiofibular ligament (AITFL) transection (condition 1A), while the contralateral underwent deltoid transection (condition 1B). Third, the lesions were reversed on the same specimens and the remaining intact deltoid or AITFL was transected (condition 2). Finally, the distal tibiofibular interosseous membrane (IOM) was transected in all ankles (condition 3). Measurements were performed to assess the integrity of the distal tibiofibular syndesmosis on digitally reconstructed radiographs (DRRs) and on axial CT scans. Results: Torque impacted DRR and axial CT scan measurements in almost all conditions. The ability to diagnose syndesmotic injuries using axial CT measurements improved when torque was applied. No significant syndesmotic morphological change was observed with or without torque for either isolated AITFL or deltoid ligament transection. Discussion: Torque application had a notable impact on two-dimensional (2-D) measurements used to diagnose syndesmotic injuries for both DRRs and axial CT scans. Because weightbearing conditions allow for standardized positioning of the foot while radiographs or CT scans are taken, the combination of axial load and torque application may be desirable. Clinical Relevance: Application of torque to the tibia impacts 2-D measurements and may be useful when diagnosing syndesmotic injuries by DRRs or axial CT images.

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