Abstract：Objective To measure the morphometric parameters of normal distal tibiofibular syndesmosis on multi-slice CT(MSCT) images for providing anatomical basis and precise confirmation of the syndesmosis separation. Methods From June 2013 to February 2016, CT data of normal-side ankle joint of 45 patients underwent CT examination on double ankle bones from Affiliated Zhongshan Hospital of Dalian University were retrospectively analyzed. The morphology of the distal tibiofibular syndesmosis was observed on CT images, and the measuring plane of the syndesmosis was 9-11 mm proximal to the tibial plafond; meanwhile, relevant parameters including the length of tibiofibular center, the width of tibiofibular clear space and the distance between the anterior margins of tibia and fibula were measured, and the differences were analyzed in each parameter by statistical methods. Results On CT images, the distal tibiofibular syndesmosis of 45 patients appeared as three kinds of shapes, including semicircular in 14 patients (31.11%), crescent in 15 patients (33.33%) and rectangular in 16 patients (65.56%). In patients with semicircular syndesmosis, the related variable including the length of tibiofibular center, the width of tibiofibular clear space and the distance between the anterior margins of tibia and fibula was (2.69±0.19) cm, (2.45±0.46) mm and (8.48±2.30) mm respectively; (2.82±0.17) cm, (2.74±0.90) mm and (6.80±1.62) mm respectively in patients with crescent syndesmosis; as well as (2.89±0.25) cm, (3.15±0.8) mm and (6.86±1.89) mm respectively in patients with rectangular syndesmosis. And the length of tibiofibular center and the width of tibiofibular clear space of semicircular syndesmosis were shorter than those of rectangular syndesmosis, and the differences were statistically significant (q=3.722, 3.602, all P values<0.05), but another parameter, the distance between the anterior margins of tibia and fibula, was longer, and the difference approached statistical significance (q=3.217, P<0.05). However, there was no statistical significance in the relevant variables of crescent syndesmosis in comparison with semicircular and rectangular syndesmosis (all P values>0.05). Conclusions The distal tibiofibular syndesmosis shows three kinds of shapes, appearing as semicircular, crescent and rectangular, yet DR images cant make a definite diagnosis of the syndesmosis separation, so tangent lines of anterior and posterior edges of distal tibiofibular syndesmosis are chosen as measurement baseline, which can improve the repeatability measurement of the relevant parameters. Therefore, this method in the study can be effective for further study of the distal tibiofibular syndesmosis in Chinese people.
禹铭杨,孙强,于晓光,菜兆成,赵德伟, 于海波,崔大平,苏云. 下胫腓联合解剖参数的多层螺旋CT测量[J]. 中华解剖与临床杂志, 2017, 22(3): 192-196.
Yu Mingyang, Sun Qiang, Yu Xiaoguang, Cai Zhaocheng, Zhao Dewei, Yu Haibo, Cui Daping, Su Yun. Anatomical parameters of normal distal tibiofibular syndesmosis on multi-slice CT images. Chinese Journal of Anatomy and Clinics, 2017, 22(3): 192-196.
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2017, Vol. 22 
