3D CT reconstruction for diagnosis of chronic lateral ankle instability combined with syndesmotic diastasis
10.3760/cma.j.cn115530-20240315-00117
- VernacularTitle:CT三维重建在慢性踝关节外侧不稳合并下胫腓联合分离中的诊断价值
- Author:
Ke FU
1
;
Jingjing ZHAO
;
Cheng HAO
;
Wei XIE
;
Shiwei LIN
;
Chenyu XU
;
Zhenhua FANG
Author Information
1. 江汉大学医学部，武汉 430056
- Keywords:
Joint instability;
Ankle;
Ligaments, articular;
Computed tomography;
Imaging, three-dimensional;
Diagnosis
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(10):865-871
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of 3D CT reconstruction in diagnosis of chronic lateral ankle instability (CLAI) combined with syndesmotic diastasis (SD).Methods:A retrospective study was conducted to analyze the clinical data of 160 patients with CLAI who had been examined by arthroscopy from January 2018 to September 2022 at Department of Foot and Ankle Surgery, Wuhan Fourth Hospital. There were 64 males and 96 females with an age of (39.8±12.6) years. Eighty-one left and 79 right feet were affected; the time from injury to surgery was (27.3±11.6) months. The patients were divided into a widened interval group and a normal interval group according to the syndesmotic width measured, with 2 mm as a critical value. After preoperative 3D CT reconstruction, the differences in anterior tibiofibular distance, posterior tibiofibular distance, the narrowest tibiofibular distance, fibular translation, fibular rotation, and syndesmotic area (SA) were compared between the 2 groups. Univariate and multivariate analyses were performed successively to identify the risk factors. The receiver operating characteristic (ROC) curve was used to identify the best predictive factor and critical value. According to the findings of previous research, the above analyses were repeated to determine the best predictive factor and critical value respectively in the sex subgroup, fibular morphology subgroup and incisura feature subgroup.Results:The binary logistic regression showed that SA was a risk factor for CLAI combined with SD ( OR=1.196, 95% CI: 1.122 to 1.275, P < 0.001). The ROC curve revealed an area under curve of 0.847 and the difference critical value of 22.06 mm 2 that indicated a sensitivity of 80.4% and a specificity of 78.9%, respectively. Subgroup analyses showed that SA was suitable for male and female patients and patients with different fibular morphologies and incisura features but the difference critical values were different. Conclusion:In 3D CT reconstruction, measurement of SA may help the diagnosis of CLAI combined with SD.
