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Updated: Jul 6, 2025

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Normal Distal Tibiofibular Syndesmosis Assessment Using Postmortem Computed Tomography (PMCT).

Jahyung Kim1, Jeong-Hyun Park2, Hyung-Wook Kwon2

  • 1Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju 11428, Republic of Korea.

Diagnostics (Basel, Switzerland)
|January 11, 2024
PubMed
Summary

Postmortem CT scans reveal wide normal variations in distal tibiofibular syndesmotic relationships. Comparing to the uninjured ankle aids diagnosis of these often-missed injuries.

Keywords:
computed tomographydistal tibiofibular relationshippostmortemsyndesmosis

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Area of Science:

  • Orthopedics
  • Radiology
  • Anatomy

Background:

  • Distal tibiofibular syndesmotic injuries are frequently misdiagnosed, leading to significant patient morbidity.
  • Accurate diagnosis requires a clear understanding of normal anatomical variations.

Purpose of the Study:

  • To establish normal reference values for distal tibiofibular syndesmotic relationships using postmortem computed tomography (PMCT).
  • To identify key parameters for diagnosing syndesmotic injuries.

Main Methods:

  • Postmortem CT scans of 131 subjects were analyzed.
  • Measurements included fibular rotation (FR), sagittal translation (ST), and incisura depth (ID).

Main Results:

  • Excellent interobserver reliability was found for FR and ID, moderate for ST.
  • Wide anatomical variability was observed across all measured parameters.
  • Gender-specific differences in ST suggest the need for tailored diagnostic criteria.

Conclusions:

  • Establishing universal reference values for syndesmotic parameters is difficult due to wide anatomical variability.
  • Comparing measurements to the contralateral (uninjured) ankle can improve diagnostic accuracy for syndesmotic injuries.
  • This study provides crucial PMCT-based data on normal syndesmotic relationships, informing future research and clinical practice.