• Sannamari Lepojärvi, Harri Pakarinen, Olli Savola, Marianne Haapea, Roberto B Sequeiros, and Jaakko Niinimäki.
• *Department of Diagnostic Radiology; and †Division of Orthopaedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland.
• J Orthop Trauma. 2014 Apr 1;28(4):205-9.

ObjectivesThe aim of our study was to assess the intersubject and intrasubject variations of distal tibiofibular syndesmosis on computed tomography (CT) scans and to define standardized measures to verify syndesmosis reduction.DesignA retrospective study of 107 CT scans of ankles with normal tibiofibular syndesmosis.SettingMain trauma center, university teaching hospital.PatientsThe CT scans of 64 patients were reviewed by 2 musculoskeletal radiologists.Main Outcome MeasurementsBilateral variation was estimated. The intra- and interobserver reliabilities were calculated using standardized measurement points. CT measurements included the length of the tibial incisura (LI), A width and P width of the incisura (PW), depth of the incisura, narrowest part of the incisura, and sagittal translation of the fibula.ResultsIn 97% of normal cases, the fibula is situated either centrally or anteriorly in the tibial incisura. There were significant differences in PW and LI between genders, and the difference between the PW and A width was significantly larger in males (2.7 mm, SD 2.1) than in females (1.9 mm, SD 1.6, P = 0.023, t test). Significant asymmetry was not detected between ankles in single subjects. All CT measurements demonstrated good inter- and intraobserver reliabilities.ConclusionsIf P translation of the fibula is present, malreduction should be considered. Sagittal translation measurements are not affected by the size of the joint or the gender of the patient, in contrast to traditionally used cross-sectional measurement methods.

27 keywords...

hide…