Morphology of the incisura fibularis in the Turkishpopulation
Morphology of the incisura fibularis in the Turkishpopulation
Aim: Morphology of the distal tibiofibular syndesmosis plays an important role in the pattern of ankle fracture and reduction strategy. This study aimed to describe the normal morphology of the distal tibiofibular syndesmosis in a Turkish population. Materials and Methods: All analyzes were based on 349 computed tomography images, contributed by 265 male and 84 female patients. The following features were measured on axial images: the depth of the incisura fibularis, anterior tibiofibular depth, posterior tibiofibular depth, anterior-posterior length of the fibula, mediolateral width of the fibula, version of the incisura fibularis, anterior tubercle length, posterior tubercle length, and tibiofibular engagement. All measure ts were performed by an orthopedic surgeon and an experienced musculoskeletal radiologist, repeated at a 2-week interval. Results: The most common morphology of the incisura fibularis was concave (C-shape, depth >4 mm, 66.5%), followed by a shallow morphology (I-shape, depth
___
- 1. Yuen CP, Lui TH. Distal Tibiofibular Syndesmosis: Anatomy, Biomechanics, Injury and Management. Open Orthop J 2017;11:670-7.
- 2. Vosseller JT, Karl JW, Greisberg JK. Incidence of syndesmotic injury. Orthopedics 2014;37:e226-9.
- 3. Gardner MJ, Demetrakopoulos D, Briggs SM, et al. Malreduction of the tibiofibular syndesmosis in ankle fractures. Foot Ankle Int 2006;27:788-92.
- 4. Liu GT, Ryan E, Gustafson E, et al. Three-dimensional computed tomographic characterization of normal anatomic morphology and variations of the distal tibiofibular syndesmosis. J Foot Ankle Surg 2018;57:1130-6.
- 5. Tochigi Y, Rudert MJ, McKinley TO, et al. Correlation of dynamic cartilage contact stress aberrations with severity of instability in ankle incongruity. J Orthop Res 2008;26:1186-93.
- 6. Harris J, Fallat L. Effects of isolated Weber B fibular fractures on the tibiotalar contact area. J Foot Ankle Surg 2004;43:3-9.
- 7. van den Bekerom MP, de Leeuw PA, van Dijk CN. Delayed operative treatment of syndesmotic instability: current concepts review. Injury 2009;40:1137-42.
- 8. Tonogai I, Hamada D, Sairyo K. Morphology of the incisura fibularis at the distal tibiofibular syndesmosis in the Japanese population. J Foot Ankle Surg 2017;56:1147-50.
- 9. Saldua NS, Harris JF, LeClere LE, et al. Plantar flexion influences radiographic measurements of the ankle mortise. J Bone Joint Surg Am 2010;92:911-5.
- 10. Elgafy H, Semaan HB, Blessinger B, et al. Computed tomography of normal distal tibiofibular syndesmosis. Skeletal Radiol 2010;39:559-64.
- 11. Sowman B, Radic R, Kuster M, et al. Distal tibiofibular radiological overlap: Does it always exist? Bone Joint Res 2012;1:20-4.
- 12. Ebinger T, Goetz J, Dolan L, et al. 3D model analysis of existing CT syndesmosis measurements. Iowa Orthop J 2013;33:40-6.
- 13. Mendelsohn ES, Hoshino CM, Harris TG, et al. CT Characterizing the anatomy of uninjured ankle syndesmosis. Orthopaedics 2014;37:e157-60.
- 14. Boszczyk A, Kwapisz S, Krummel M, et al. Correlation of incisura anatomy with syndesmotic malreduction. Foot Ankle Int 2018;39:369-75.
- 15. Shah AS, Kadakia AR, Tan GJ, et al. Radiographic evaluation of the normal distal tibiofibular syndesmosis. Foot Ankle Int 2012;33:870-6.
- 16. Taser F, Toker S, Kilincoglu V. Evaluation of morphometric characteristics of the fibular incisura on dry bones. Eklem Hastalik Cerrahisi 2009;20:52-8.
- 17. Mavi A, Yildirim H, Gunes H, et al. The fibular incisura of the tibia with recurrent sprained ankle on magnetic resonance imaging. Saudi Med J 2002;23:845-9.
- 18. Hocker K, Pachucki A. The fibular incisure of the tibia: the cross-sectional position of the fibula in distal syndesmosis [in German]. Unfallchirurg 1989;92:401- 6.
- 19. Ebraheim NA, Lu J, Yang H, et al. The fibular incisure of the tibia on CT scan: a cadaver study. Foot Ankle Int 1998;19:318-21.
- 20. Yeung TW, Chan CY, Chan WC, et al. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years’ experience in a tertiary trauma center. Skeletal Radiol 2015;44:823-9.
- 21. Pelton K, Thordarson DB, Barnwell J. Open versus closed treatment of the fibula in Maisonneuve injuries. Foot Ankle Int 2010;31:604-8.
- 22. Chen Y, Qiang M, Zhang K, et al. A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi-detector computed tomography study in adults. J Foot Ankle Res 2015;8:32.
- 23. LaMothe J, Baxter JR, Gilbert S, et al. Effect of complete syndesmotic disruption and deltoid injuries and different reduction methods on ankle joint contact mechanics. Foot Ankle Int 2017;38:694-700.
- 24. Haynes J, Cherney S, Spraggs-Hughes A, et al. Increased reduction clamp force associated with syndesmotic overcompression. Foot Ankle Int 2016;37:722-9.
- 25. Cherney SM, Spraggs-Hughes AG, McAndrew CM, et al. Incisura morphology as a risk factor for syndesmotic malreduction. Foot Ankle Int 2016;37:748-54