A simplified, validated protocol for measuring fibular reduction on ankle CT

Prior, Christopher P.; Widnall, James; Rehman, Amer; Weller, David Marc; Wood, Edward V.

doi:10.1016/j.fas.2016.02.005

Cited by 28 publications

(31 citation statements)

References 24 publications

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“…Specifically, tibia and fibula displacement in the anterior-posterior (AP) direction is not sufficiently observable in a radiograph’s AP view [ 17 ]. In such cases, CT scans can be an alternative diagnostic tool for presenting morphologic information and providing measured quantitative data to predict a syndesmotic ankle injury [ 14 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have adopted different tools for optimal diagnosis because of the highly distinct variations in measurements and discrepancies between image and intraoperative inspections of syndesmotic injuries. In addition, the parameters suggested in prior studies were based on Western patients, whose physiques differ from most Asians [ 10 , 14 , 15 , 16 , 17 ]. Therefore, we utilized bilateral imaging to compare and minimize the differences between populations and individuals.…”

Section: Discussionmentioning

confidence: 99%

“…We speculated that a two-dimensional surface area would stand out with better spatial comprehension of anatomic structures between the tibia and the fibula. The SAS 1.0 was measured 1.0 cm above the tibial plafond, which represents the deepest part of the incisura fibulae, similar to previous studies that utilized axial CT scans [ 9 , 12 , 13 , 14 ]. When more than one transfixation between tibia and fibula is performed, the area 15 mm above it is commonly transfixed [ 9 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are many approaches to measuring, evaluating, and predicting syndesmotic injuries. TFCS and TFO are relatively well-known measurements that can be acquired via plain radiography [ 5 , 14 ]. Predicting syndesmotic injuries requires the evaluation of specific parameters, namely: anterior fibular distance (AFD), posterior fibular distance (PFD), anterior translation distance (AT), fibular diastasis (FD), anterior-posterior translation (APT), and fibular length (FL) [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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The Valid Diagnostic Parameters in Bilateral CT Scan to Predict Unstable Syndesmotic Injury with Ankle Fracture

Lee

Park

et al. 2020

Diagnostics

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The purpose of this study is to evaluate the reasonable parameters to predict unstable syndesmotic injuries in ankle fractures. Seventy consecutive patients who underwent preoperative bilateral computed tomography (CT) scans were enrolled. Group A consisted of 20 patients intraoperatively diagnosed with syndesmotic injuries according to an intraoperative stress test and group B consisted of 50 patients who had nosyndesmotic injuries. The tibiofibular overlap (TFO) and tibiofibular clear space (TFCS) were measured using preoperative ankle radiographs. Measuring the anterior fibular distance (AFD), posterior fibular distance (PFD), anterior translation distance (AT), fibular diastasis (FD), anterior-posterior translation (APT), fibular length (FL), and surface area of syndesmosis (SAS) 1.0 and 1.5 which 1.0 cm and 1.5 cm above the tibial plafond was done via preoperative CT scan. The ratio of measurements (Injured/Intact) of the TFO, PFD, APD, and SAS 1.0 showed statistically significant differences. The researchers identified the SAS 1.0 as the most reasonable parameter to predict transfixation using receiver-operating characteristic (ROC) curve analysis. The SAS 1.0 is most valid parameter to predict syndesmotic injuries in this study and these results show that performing a bilateral CT scan on an ankle fracture may provide substantial information in measuring valid parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Valid Diagnostic Parameters in Bilateral CT Scan to Predict Unstable Syndesmotic Injury with Ankle Fracture

Lee

Park

et al. 2020

Diagnostics

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“…Currently, a variety of different CT measurements have already been described. 11,25,27 However, they are only performed in 2D on 1 slice, missing the spatial CT volume data and possibly inducing measurement errors if the incorrect slice is selected. 20 The proposed method may help overcome these problems by segmenting a volume out of bilateral ankle CTs; the healthy ankle was used as a template after being mirrored and superimposed on the contralateral pathological ankle with a syndesmotic lesion.…”

mentioning

confidence: 99%