Morphology of the proximal tibiofibular joint does not affect the type of lateral malleolus fracture and syndesmotic ligament injuries: A computed tomography-based study

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2024-12-01 DOI:10.1016/j.fas.2024.05.017

Ali Yüce , Mustafa Yerli , Nazım Erkurt , Can Burak Özkan , Sözdar Güzel

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引用次数: 0

Abstract

Introduction

The Proximal Tibiofibular Joint (PTFJ) is a synovial joint with anatomical variations located between the anteromedial surface of the fibula and the posterolateral facet of the tibia. These anatomical variations are believed to contribute to different biomechanical behaviors in both the knee and ankle joint and play a role in both physiological and pathological movements. Therefore, the morphology of the proximal tibiofibular joint may play a decisive role in the characteristics of ankle fractures and syndesmotic ligament injuries.

Materials and methods

In this retrospective comparative our CT database was searched between January 2015 and December 2022. Following inclusion criteria were used: Availability of knee CT scans for the fractured ankle, external rotation-type injuries (pronation external rotation and supination external rotation fractures). After applying the exclusion criteria (Plafond fractures, supination adduction and pronation abduction type fractures, pathological fractures, patients with previous fractures or surgeries around the knee, patients with previous fractures or surgeries around the knee, proximal tibiofibular arthrosis), 44 CT scans (mean age = 42.8 ± 14.1) confirmed eligible for further analysis. On each scan following measurements were performed: Coronal and sagittal PTFJ inclination angle, Joint obliquity, fibula head-tibia joint distance and tibia plateau-fibular axis angle.

Results

The study consisted of 24 (54.5 %) male and 20 (45.5 %) female patients. According to the proximal fibular inclination, 29 cases (65.9 %) were of the oblique type, and 15 cases (34.1 %) were of the horizontal type. The distribution of PTFJ variations was as follows: 17 (38.6 %) concave, 4 (9.1 %) convex, 7 (15.9 %) atypical, and 16 (36.4 %) flat type. Regarding the PTFJ joint contour, the distribution was 13 (29.5 %) type a, 11 (25 %) type b, and 20 (45.5 %) type c. There was no relationship between measurements of PITFJ morphology and the type of ankle fracture and/or syndesmosis injury (p > 0.05).

Conclusion

PTFJ morphological features are not associated with rotational ankle fractures and syndesmotic ligament injuries.

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胫腓骨近端关节的形态并不影响外侧踝骨骨折和滑膜韧带损伤的类型：基于计算机断层扫描的研究

近端胫腓骨关节（PTFJ）是一种滑膜关节，位于腓骨前内侧面和胫骨后外侧关节面之间。这些解剖变异被认为有助于膝关节和踝关节的不同生物力学行为，并在生理和病理运动中发挥作用。因此，近端胫腓关节的形态可能在踝关节骨折和韧带联合损伤的特征中起决定性作用。材料和方法在这项回顾性比较中，我们检索了2015年1月至2022年12月的CT数据库。采用以下纳入标准：踝关节骨折、外旋型损伤（旋前外旋和旋后外旋骨折）的膝关节CT扫描的可用性。应用排除标准（平台骨折、旋后内收、旋前外展型骨折、病理性骨折、既往膝关节周围骨折或手术患者、既往膝关节周围骨折或手术患者、胫腓近端关节）后，44例CT扫描（平均年龄= 42.8±14.1）确认符合进一步分析的条件。在每次扫描中进行以下测量：冠状面和矢状面PTFJ倾角，关节倾角，腓骨头-胫骨关节距离和胫骨平台-腓骨轴角。结果本组患者男性24例（54.5%），女性20例（45.5%）。根据腓骨近端倾斜度，29例（65.9%）为斜型，15例（34.1%）为水平型。PTFJ变异分布如下：凹型17例（38.6%），凸型4例（9.1%），不典型型7例（15.9%），平型16例（36.4%）。关于PTFJ关节轮廓，分布为a型13例（29.5%），b型11例（25%），c型20例（45.5%）。PITFJ形态测量与踝关节骨折和/或联合损伤类型之间没有关系(p >；0.05)。结论ptfj形态学特征与踝关节旋转骨折及韧带联合损伤无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.