Distal tibiofibular radiological overlap

Sowman, B.; Radic, Ross; Kuster, Markus S.; Yates, Piers; Breidiel, B.; Karamfilef, S.

doi:10.1302/2046-3758.12.2000048

Cited by 17 publications

(12 citation statements)

References 16 publications

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“…In suspected cases, further investigations can be performed using CT, magnetic resonance imaging or ankle arthroscopy. However, important decisions are made by taking measurements with XR since these tests are costly and require specialty (15). However, axial CT has been reported to be much better than conventional radiography for the evaluation of syndesmosis, and in our day, some authors use CT for postoperative evaluation of reduction (21).…”

Section: Discussionmentioning

confidence: 99%

Comparison of radiography and computed tomography in emergency department evaluation of ankle trauma

Avcı¹,

Kozacı²,

Yüksel³

et al. 2019

Ann Med Res

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The aim of this study was to compare computed tomography (CT) and radiography (XR) images of patients presented to the emergency department with ankle trauma and undergone CT imaging, and to describe the fractures for which XR is insufficient and the characteristics of these fractures. Material and Methods: This retrospectively designed study included patients presented to the emergency department with ankle trauma between January 2016 and December 2017. Patients who had ankle trauma, who performed XR and CT imaging were included in the study. The XR and CT images were reinterpreted by a radiologist. Results: Three hundred and sixteen patients were enrolled in the study. Of the patients, 137 (43.4%) had fracture on XR and 168 (53.2%) had fracture on CT. The most common bone fractures were detected lateral malleolus and distal tibia fractures. The sensitivity and specificity of XR in detecting fracture compared to CT were 75% and 93%, respectively. Sixty-three (20%) of the patients had two simultaneous fractures. The sensitivity and specificity of XR in detecting two simultaneous fractures were 56% and 94%, respectively. Twelve (3.8%) of the patients had distal tibial, medial malleolus and lateral malleolus fractures (trimalleolar fracture). The sensitivity and specificity of XR in detecting trimalleolar fracture were 17% and 100%, respectively. Conclusion: XR has a low sensitivity in identifying ankle fractures. The sensitivity is much lower in cases of two simultaneous fractures and trimalleolar fractures. Therefore, CT imaging should be preferred in patients with complex ankle injuries.

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Section: Discussionmentioning

confidence: 99%

Comparison of radiography and computed tomography in emergency department evaluation of ankle trauma

Avcı¹,

Kozacı²,

Yüksel³

et al. 2019

Ann Med Res

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“…The observed statistically significant difference of the tibiofibular overlap between MIPO and ORIF might be accidental, with a large variety of this value described in the literature [ 47 ]. In general, the tibiofibular overlap should be greater than or equal to 10 mm [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive plate osteosynthesis (MIPO) versus open reduction and internal fixation (ORIF) in the treatment of distal fibula Danis-Weber types B and C fractures

et al. 2020

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Background Minimally invasive plate osteosynthesis (MIPO) has been reported to be superior to open reduction and internal fixation (ORIF) in the treatment of different long bone fractures. Nevertheless, in distal fibula fractures, the evidence of MIPO remains scarce. The aim of this retrospective study was to compare the clinical and radiological outcomes of the minimally invasive techniques applied to the distal fibula with open reduction and internal fixation within a 12 months follow-up. Methods A consecutive series of patients who underwent surgery using either ORIF or MIPO for the treatment of distal fibula fractures between 2010 and 2014 were retrospectively analyzed. All distal fibular fractures requiring an operative treatment (Danis-Weber type B ≙ AO type 44 B1, 2, 3 and Danis-Weber type C ≙ AO type 44 C1, 2) were included (ORIF n = 35, MIPO n = 35). Patients were assessed for postoperative pain using a visual analog scale (VAS) for pain (ranging from 0 to 10) and classified into 4 groups: “no pain” for VAS = 0, “low” for VAS = 1–3, “moderate” for VAS = 3–5, and “severe” for VAS = 5–10. In addition, complications of postoperative fracture-related infection, wound healing disorders, vascular and nerve injury and development of nonunion were evaluated and analyzed. Radiologic outcome measures assessing the talocrural angle, lateral and medial clear space, tibiofibular overlap, and talar tilt angle were evaluated postoperatively. Results The overall complication rate showed to be lower in the MIPO group compared to the ORIF group (14% vs. 37%, p = 0.029). Even though not statistically significant, specific surgery-related complications such as skin necrosis (3% vs. 9%, p = 0.275), nonunion (0% vs. 6%, p = 0.139), infections and wound healing disorders (9% vs. 20%, p = 0.141), as well as postoperative pain (17% vs. 26%, p = 0.5) were found more frequently in the ORIF group. The tibiofibular overlap demonstrated to be significantly lower in the ORIF group (3.3 mm vs. 2.7 mm, p = 0.033). The talocrural angle, talar tilt angle, and lateral and medial clear space showed to be equivalent in both groups. Conclusion In this retrospective single-center consecutive series, MIPO was superior to ORIF in the surgical treatment of distal fibula fractures with respect to the overall complication rate. Trial registration EKNZ Project-ID: 2019-02310, registered on the 20th of December 2019 with swissethics

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“…Pneumaticos dkk mengatakan tibiofibular overlap selalu ada disetiap pemeriksaan x-ray pergelangan kaki, namun apabila tibiofibular overlap tidak ditemukan maka kemungkinan terdapat cedera pada syndesmosis dan diperlukan fiksasi pada syndesmosis (disitasi dari Sowman, 2012). 19 Sowman dkk dalam penelitiannya menemukan adanya variasi anatomi normal dimana tidak terdapatnya tibiofibular overlap tanpa adanya cedera pada syndesmosis, dimana dari 324 pasien yang ditelitinya ditemukan 4 pasien (1,23%) tidak terdapat tibiofibular overlap. 19 Pada penelitan ini ditemukan satu subjek yang tidak memiliki tibiofibular overlap tanpa adanya cedera pada syndesmosis.…”

Section: Pendahuluanunclassified

“…19 Sowman dkk dalam penelitiannya menemukan adanya variasi anatomi normal dimana tidak terdapatnya tibiofibular overlap tanpa adanya cedera pada syndesmosis, dimana dari 324 pasien yang ditelitinya ditemukan 4 pasien (1,23%) tidak terdapat tibiofibular overlap. 19 Pada penelitan ini ditemukan satu subjek yang tidak memiliki tibiofibular overlap tanpa adanya cedera pada syndesmosis. Pemeriksaan yang lebih baik untuk menentukan cedera syndesmosis adalah dengan pemeriksaan MRI, namun pemeriksaan ini tidak tersedia disemua fasilitas kesehatan dan memerlukan biaya yang lebih tinggi.…”

Section: Pendahuluanunclassified