대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제21권4호
  • /
  • Pages.128-134
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  • 2017
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
권호 표지
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원위경비인대결합 손상 정복 후 관찰된 측면 방사선 영상의 임상적 중요성

Clinical Significance of Lateral Ankle Radiograph after the Reduction of a Syndesmosis Injury

  • 서재완 (단국대학교 의과대학 정형외과학교실) ;
  • 박현우 (단국대학교 의과대학 정형외과학교실)
  • Suh, Jae Wan (Department of Orthopedic Surgery, Dankook University College of Medicine) ;
  • Park, Hyun-Woo (Department of Orthopedic Surgery, Dankook University College of Medicine)
  • 투고 : 2017.10.17
  • 심사 : 2017.10.30
  • 발행 : 2017.12.15
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초록

Purpose: To introduce reliable and newly developed radiographic measures based on a lateral ankle radiograph to assess a syndesmotic reduction after screw fixation and to compare with the radiographic measures based on the anteroposterior (AP) and mortise radiographs. Materials and Methods: The postoperative ankle radiographs of 34 ankle fracture cases after screw fixation for concurrent syndesmosis injury were reviewed. Two radiographic parameters were measured on each AP and mortise radiograph; tibiofibular clear space (TFCS) and tibiofibular overlap (TFO). Five radiographic parameters were measured on the true lateral radiographs; the anteroposterior tibiofibular (APTF) ratio, anterior tibiofibular ratio (ATFR), posterior tibiofibular ratio (PTFR), distances of intersection of the anterior fibular border and the tibial plafond to anterior cortex of the tibia (AA'), and the intersection of posterior fibular border and tibial plafond to the tip of the posterior malleolus (BB'). In addition, the distance (XP) between the fibular posterior margin (X) crossing tibial plafond or the posterior malleolus and posterior articular margin (P) of the tibial plafond was measured on the lateral view. Results: Using TFCS and TFO in the AP and mortise radiographs, malreductions of syndesmosis were estimated in 17 of 34 cases (50.0%). Using the introduced and developed radiographic measures in the lateral radiographs, syndesmotic malreductions were estimated in 16 out of 34 cases (47.1%). Seventeen cases (50.0%) showed no evidence of postoperative diastasis using the radiographic criteria on the AP and mortise view, 10 cases (58.8%) of whom showed evidence of a malreduction on the lateral radiograph. The newly developed measurements, XP, were measured 0 in 11 out of 34 cases (32.4%). Conclusion: The reduction of syndemosis after screw fixation can be accurately assessed intraoperatively with a combination of several reliable radiographic measurements of the lateral radiograph and traditional radiographic measurements of the AP and mortise radiograph.

키워드

참고문헌

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