Abstract
The morphology of the distal tibiofibular syndesmosis can determine the pathology
and mechanism of syndesmotic injury. The present study assessed measurements obtained
from computed tomography (CT) images of the normal distal tibiofibular syndesmosis
in Japanese subjects. CT scans of 120 right feet with a normal distal tibiofibular
syndesmosis obtained from January 2009 to December 2016 were retrospectively assessed
at the level 10 mm proximal to the tibial plafond. The incisura fibularis was considered
concave when its depth was ≥4 mm and shallow when its depth was <4 mm. The depth of
the incisura fibularis, anterior tibiofibular distance (TFD), posterior TFD, and longitudinal/transverse
length of the distal fibula were measured. The incisura fibularis was concave in 64.2%
of the feet and shallow in 35.8%. The mean anterior TFD was 2.2 ± 0.8 mm (2.4 ± 0.8 mm
in males; 2.1 ± 0.8 mm in females; 2.1 ± 0.8 mm for concave; 2.2 ± 0.9 mm for shallow).
The mean posterior TFD was 5.9 ± 1.6 mm (6.7 ± 2.1 in males; 5.7 ± 1.3 mm in females;
5.5 ± 1.3 mm for concave; 6.5 ± 1.9 mm for shallow). The mean longitudinal/transverse
length of the distal fibula at the level of the syndesmosis was 1.2 mm (1.3 mm in
males; 1.2 mm in females; 1.1 mm for concave; 1.3 mm for shallow). The mean posterior
TFD was significantly greater than the mean anterior TFD and was also significantly
greater in males than in females. Significant differences were found in the body mass
index, posterior TFD, and longitudinal/transverse length of the distal fibula according
to whether the incisura fibularis was concave or shallow. The present study has provided
measurements of the normal tibiofibular syndesmosis in the Japanese population. These
data suggest that the morphology of the syndesmosis varies, especially with respect
to whether the incisura fibularis is concave or shallow.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 16, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
