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Tibiofibular syndesmosis in asymptomatic ankles: initial kinematic analysis using four-dimensional CT
A Mousavian1, D Shakoor2, N Hafezi-Nejad2
1Department of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Clinical Radiology
|May 12, 2019
Summary
Four-dimensional computed tomography (4DCT) reliably assesses ankle syndesmosis in asymptomatic individuals. Syndesmotic translation measurements showed significant changes during active motion, decreasing with plantar flexion.
Area of Science:
- Orthopedics
- Radiology
- Biomechanics
Background:
- Ankle syndesmotic injuries are common and can lead to chronic pain and instability.
- Accurate assessment of syndesmotic integrity is crucial for diagnosis and treatment.
- Four-dimensional computed tomography (4DCT) offers dynamic imaging capabilities for evaluating joint motion.
Purpose of the Study:
- To evaluate the reliability of five ankle syndesmotic measurements using 4DCT in asymptomatic ankles.
- To assess changes in these measurements during active ankle motion.
Main Methods:
- 10 asymptomatic ankles from patients with unilateral instability underwent 4DCT.
- Five syndesmotic measurements were performed by two surgeons: SAD, SPD, ST, STFA, ATFA.
- Monte Carlo simulations were used for statistical analysis.
Main Results:
- Excellent interobserver reliability was found for four of five measurements (ICC 0.767-0.995).
- Syndesmotic anterior distance (SAD) showed no significant reliability.
- Only syndesmotic translation (ST) measurements significantly changed during active motion, decreasing with plantar flexion.
Conclusions:
- 4DCT provides reliable quantitative kinematic assessment of the ankle syndesmosis.
- Syndesmotic measurements are generally stable during motion, with ST showing a decrease during plantar flexion.
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