Normal Values for Distal Tibiofibular Syndesmotic Space With and Without Subject-Driven External Rotation Stress.
Background: The diagnosis and treatment of distal tibiofibular syndesmosis (DTFS) injury can be challenging, especially in cases of subtle instability that may be masked on 2-dimensional conventional radiographs. Weightbearing computed tomography (WBCT) has recently emerged as a useful diagnostic to...
| Publicado en: | Foot & Ankle International Vol. 45; no. 1; pp. 80 - 86 |
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| Autores principales: | , , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Jan2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=175032784&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 175032784 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10711007 DBG jtl: Foot & Ankle International issn: 10711007 maglogo: Y pubinfo: dt: Jan2024 vid: 45 iid: 1 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 175032784 173266958 175032784 175032784 10.1177/10711007231205576 175032784 ppf: 80 ppct: 6 formats: tig: atl: Normal Values for Distal Tibiofibular Syndesmotic Space With and Without Subject-Driven External Rotation Stress. aug: au: Shamrock, Alan Den Hartog, Taylor J. Dowley, Kieran Day, Jonathan Barbachan Mansur, Nacime Salomao Carvalho, Kepler Alencar Mendes de de Cesar Netto, Cesar O'Malley, Martin affil: Hospital for Special Surgery, New York, NY, USA sug: subj: Reference Values Joint Instability Radiography Ankle Sprain, Syndesmosis Surgery Rotation Ankle Sprain Ankle Joint Anatomy and Histology Human Tomography, X-Ray Computed Methods Body Positions Weight-Bearing Prospective Studies Talus Physiology T-Tests Young Adult Adult Confidence Intervals Cross Sectional Studies Descriptive Statistics Adult: 19-44 years ab: Background: The diagnosis and treatment of distal tibiofibular syndesmosis (DTFS) injury can be challenging, especially in cases of subtle instability that may be masked on 2-dimensional conventional radiographs. Weightbearing computed tomography (WBCT) has recently emerged as a useful diagnostic tool allowing direct assessment of distal tibiofibular area widening. The purpose of the current study was to examine and report normal threshold values for DTFS area measurements in a cohort of healthy volunteers, assessing the ankles in natural weightbearing position and under subject-driven external rotation stress. Methods: In this prospective study, we enrolled 25 healthy volunteers without a history of DTFS injury or high ankle sprain, previous foot and ankle surgery, or current ankle pain. Subjects with any prior ankle injuries were excluded. Study participants underwent bilateral standing nonstress and external rotation stress WBCT scans. The DTFS area (mm2) was semiautomatically quantified on axial-plane WBCT images 1 cm proximal to the apex of the talar dome using validated software. Syndesmosis area values were compared between "unstressed" and "stressed" ankles, as well as left and right ankles. Statistical analysis was performed using independent t tests/Wilcoxon analysis with statistical significance defined as P <.05. Results: The study cohort consisted of 50 ankles in 25 patients (12 males, 48%) with a mean age of 28.7 ± 9.3 years. In the unstressed ankle, the mean pooled DTFS area was determined to be 103.8 + 20.8 mm2. The mean syndesmosis area of unstressed left ankles (104.2 + 19.5 mm2) was similar to unstressed right ankles (109.2 + 17.2 mm2) in the cohort (P =.117). With external rotation stress, the DTFS area of left ankles (mean difference −0.304 mm2, CI −12.1 to 11.5; P =.082), right ankles (mean difference −5.5 mm2, CI 16.7-5.7; P =.132), and all ankles (mean difference −2.9 mm2, CI −10.8 to 5.1; P =.324) remained similar. Conclusion: This study presents normal values and range for DTFS area calculation. In uninjured ankles with expected intact ligaments, subject-driven external rotation stress did not result in significant widening of the DTFS space as imaged on with WBCT. Level of Evidence: Level II, cross-sectional study. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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