Defining the three most responsive and specific CT measurements of ankle syndesmotic malreduction View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-24

AUTHORS

Jason M. Schon, Alex W. Brady, Joseph J. Krob, Carly A. Lockard, Daniel C. Marchetti, Grant J. Dornan, Thomas O. Clanton

ABSTRACT

PurposeThe purpose of this study was to compare the reliability and accuracy of existing computed tomography (CT) methods for measuring the distal tibiofibular syndesmosis in uninjured, paired cadaveric specimens and in simulated malreduction models. It was hypothesized that a repeatable set of measurements exists to accurately and quantitatively describe the typical forms of syndesmotic malreduction using contralateral ankle comparison.MethodsTwelve cadaveric lower-leg specimen pairs were imaged with CT to generate models for this study. Thirty-five measurements were performed on each native model. Next, four distinct fibular malreductions were produced via digital simulation and all measurements were repeated for each state: (1) 2-mm lateral translation; (2) 2-mm posterior translation; (3) 7-degree external rotation; (4) the previous three states combined. The modified standardized response mean (mSRM) was calculated for each measurement. To assess rater reliability and side-to-side agreements of the native state measurements, intraclass correlation coefficients (ICC) and Pearson correlation coefficients (PCC) were calculated, respectively.ResultsThe most responsive measurements for detecting isolated malreduction were the Leporjärvi clear space for lateral translation, the Nault anterior tibiofibular distance for posterior translation, and the Nault talar dome angle for external rotation of the fibula. These measurements demonstrated fair to excellent inter-rater ICCs (0.64–0.76) and variable side-to-side PCCs (0.14–0.47).ConclusionsThe most reliable method to assess the syndesmosis on CT was to compare side-to-side differences using three distinct measurements, one for each type of fibular malreduction, allowing assessment of the magnitude and directionality of syndesmosis malreduction. Reliable evaluation is essential for assessing subtle syndesmosis injuries, malreduction and surgical planning. More... »

PAGES

2863-2876

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-019-05457-8

DOI

http://dx.doi.org/10.1007/s00167-019-05457-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113668382

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31020353


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