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Is load application necessary when using computed tomography scans to diagnose syndesmotic injuries? A cadaver study
Nicola Krähenbühl1, Travis L Bailey2, Maxwell W Weinberg1
1Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.
Summary
Weightbearing computed tomography (CT) scans did not improve the assessment of distal tibiofibular syndesmotic injuries in cadavers. Subtle injuries remained undetectable, while only more severe injuries were identifiable with axial CT imaging.
Area of Science:
- Orthopedic Surgery
- Radiology
- Biomechanics
Background:
- Distal tibiofibular ligament injuries are common but subtle syndesmotic injuries are difficult to diagnose.
- Conventional radiographs have limitations in assessing these subtle injuries.
- Weightbearing computed tomography (CT) may offer improved diagnostic capabilities.
Purpose of the Study:
- To determine the impact of loading on the assessment of incomplete and complete distal tibiofibular syndesmotic injuries using weightbearing CT scans in a cadaver model.
Main Methods:
- Fourteen paired male cadavers underwent non-weightbearing and weightbearing CT scans.
- Sequential ligamentous and interosseous membrane transections simulated varying degrees of syndesmotic injury.
- Eight measurements were performed on axial CT images to assess syndesmotic integrity.
Main Results:
- Load application did not significantly affect most syndesmotic measurements.
- Incomplete syndesmotic injuries were not identifiable with axial CT.
- More complete injuries were distinguishable from native ankles using axial CT.
Conclusions:
- In a cadaver model, load application does not enhance the assessment of distal tibiofibular syndesmotic injuries via axial CT.
- Axial CT can identify more complete syndesmotic injuries but not incomplete ones, even with loading.
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