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A simplified, validated protocol for measuring fibular reduction on ankle CT.

Christopher Patrick Prior1, James Christopher Widnall1, Amer Kemall Rehman1

  • 1Countess of Chester Hospital, Liverpool Road, Chester, Cheshire CH2 1UL, United Kingdom.

Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons
|February 5, 2017
PubMed
Summary
This summary is machine-generated.

A new ankle CT measurement protocol accurately assesses distal fibular positioning, improving outcomes for complex ankle fractures. This validated method enhances clinical assessment of post-operative mal-alignment.

Keywords:
Ankle fractureComputerised tomographyDiastasisMalreductionSyndesmosis

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Area of Science:

  • Orthopedic surgery
  • Radiology
  • Medical imaging analysis

Background:

  • Inadequate ankle syndesmotic reduction frequently leads to poor surgical outcomes.
  • Current computed tomography (CT) measurement techniques for ankle mal-positioning lack comprehensive assessment and reproducibility.
  • A standardized protocol is needed to accurately measure the distal tibiofibular relationship.

Purpose of the Study:

  • To design and validate a novel CT measurement protocol for assessing the distal tibiofibular relationship.
  • To quantify fibular diastasis, antero-posterior translation (APT), and fibular length.
  • To establish a reliable method for evaluating post-operative ankle mal-alignment.

Main Methods:

  • A new protocol was developed to measure fibular diastasis, APT, and fibular length on CT images.
  • CT scans of 16 uninjured ankles were analyzed using the new protocol and a comparative method.
  • Inter- and intra-observer agreement were assessed to determine the protocol's reliability.

Main Results:

  • The developed protocol demonstrated excellent inter-observer (r=0.994) and intra-observer (r=0.999) agreement.
  • This significantly outperformed a comparative protocol, which showed lower agreement scores (r=0.218 and r=0.820).
  • The protocol is simple, accurate, and reproducible for measuring key parameters of distal tibiofibular alignment.

Conclusions:

  • The validated ankle CT measurement protocol is accurate, reproducible, and user-friendly.
  • It serves as a valuable tool for clinicians to quantify post-operative distal fibular mal-positioning.
  • Routine use of this protocol in post-operative imaging may improve understanding and outcomes in complex ankle fracture treatment.