Distal tibiofibular syndesmosis fibular notch typing and its clinical significance based on CT

YIN Shi-Qin; YANG Si-Yi; WANG Rui-Han; YOU Gui-Xuan; YANG Ying-Qiu; ZHANG Lei

doi:10.16098/j.issn.0529-1356.2024.01.012

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Acta Anatomica Sinica ›› 2024, Vol. 55 ›› Issue (1) : 82-87. DOI: 10.16098/j.issn.0529-1356.2024.01.012

Anatomy

Distal tibiofibular syndesmosis fibular notch typing and its clinical significance based on CT

YIN Shi-qin¹ YANG Si-yi² WANG Rui-han^1,3 YOU Gui-xuan¹ YANG Ying-qiu² ZHANG Lei^4,5*

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Abstract

Objective To investigate the morphological typing and clinical significance of the distal tibiofibular syndesmosis fibular notch based on CT images. Methods According to the inclusion and exclusion ceiteria, the imaging data of patients undergoing ankle joint CT examination were analyzed, and the inferior tibiofibular joint fibula notch was classified according to the morphological characteristics. The measurements included 8 distances. There were 123 males and 102 females, all of whom were Han nationality, aged 18-60 years old. Results Retrospectively analyzed the result of 225 patients from December 2013 to December 2022. The distal tibiofibular syndesmosis fibular notch was divided into four types according to morphological characteristics, C-shaped (50.67%), V-shaped (26.67%), flat-shaped (15.11%) and L-shaped (7.56%). The angle between the anterior and posterior facets of the flat shape (145.56 ± 9.25)° was the largest and the angle between the anterior and posterior facets of the L shape (125.07 ± 13.54)° was the smallest(P<0.05); the depth of the notch in the flat shape (3.11 ± 0.83) mm was the smallest and in the L shape (4.47±1.11) mm was the largest(P<0.05);The posterior facet length (13.06 ± 3.56) mm and anterior tibiofibular gap (3.83±1.49) mm on left were larger than on the right side (P<0.05); The posterior facet length (13.36 ± 3.46) mm, fibular notch depth (3.93 ± 1.10) mm and vertical distance of tibiofibular overlap (9.10 ± 2.55) mm larger in men than in women (P<0.05). Conclusion In this study, the data related to the inferior tibiofibular syndesmosis notch were measured and divided into four types according to the shape. The flat inferior tibiofibular syndesmosis notch is more likely to have chronic ankle instability, and the fibula is more likely to move forward during anatomical reduction. The inferior tibiofibular syndesmosis of L-shaped and C-shaped notches is more prone to posterior displacement of fibula or poor rotation reduction during anatomical reduction.

Key words

Distal tibiofibular syndesmosis fibular notch / Typing / Anatomical reduction / Ankle joint in stability / Computerized tomography / Anatomy / Human

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YIN Shi-qin YANG Si-yi WANG Rui-han YOU Gui-xuan YANG Ying-qiu ZHANG Lei. Distal tibiofibular syndesmosis fibular notch typing and its clinical significance based on CT[J]. Acta Anatomica Sinica. 2024, 55(1): 82-87 https://doi.org/10.16098/j.issn.0529-1356.2024.01.012

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