Modification of Distal Tibiofibular Relationship After a Mild Syndesmotic Injury.
BACKGROUND
The hypothesis of this study is that a sprain or tear of 1 or more of the 3 syndesmotic ligaments will result in a significant change in the osseous anatomy relationship when comparing injured to uninjured syndesmosis. Our secondary objective was to determine whether injuries to the syndesmosis as diagnosed on magnetic resonance imaging (MRI) could be found using static imaging.


METHODS
This is a descriptive radiological study of ankle MRI reports over a 12-year period, from 2 different institutions, and divided in two groups: normal and injured syndesmotic ligaments. A series of 6 lengths and 2 angles were measured on MRI axial views that describe the rotation, lateral, and anteroposterior translational relation between the distal tibia and fibula. Parameters from injured and uninjured ankles were compared using Student's t-test.


RESULTS
Fifty uninjured syndesmosis were compared to 64 injured syndesmoses. The majority of syndesmosis injuries concerned either an anterior inferior tibiofibular ligament sprain or tear. There was a significant difference in the anatomic position of the tibia and the fibula between injured and uninjured syndesmosis.


CONCLUSIONS
The anterior inferior tibiofibular ligament is the most commonly injured ligament in the syndesmosis in sports injury and results in subtle variations in the syndesmotic anatomy, which plain radiographs cannot assess. Because of the previously validated computed tomography scan measurement, this study demonstrates a potential to identify syndesmotic injury on other more accessible imaging modalities, such as computed tomography scan, by using a well-defined measurement system.


METHODS
Diagnostic, Level III : Retrospective, Radiologic Study.
CHU Ste-Justine, Montreal, Québec, Canada (MN, LG).|Children's Hospital Boston, Boston, MA, USA (DK).|Hôpital du Sacré-Coeur de Montréal, Montréal, Canada (MN, JH, SL, GYL).|Surgery Department, Université de Montréal, Montreal, Canada (MN, JH, SL, GYL).
Marie-Lyne
ML
Nault
CHU Ste-Justine, Montreal, Québec, Canada (MN, LG).|Children's Hospital Boston, Boston, MA, USA (DK).|Hôpital du Sacré-Coeur de Montréal, Montréal, Canada (MN, JH, SL, GYL).|Surgery Department, Université de Montréal, Montreal, Canada (MN, JH, SL, GYL).
Laurence
L
Gascon
CHU Ste-Justine, Montreal, Québec, Canada (MN, LG).|Children's Hospital Boston, Boston, MA, USA (DK).|Hôpital du Sacré-Coeur de Montréal, Montréal, Canada (MN, JH, SL, GYL).|Surgery Department, Université de Montréal, Montreal, Canada (MN, JH, SL, GYL).
Jonah
J
Hébert-Davies
CHU Ste-Justine, Montreal, Québec, Canada (MN, LG).|Children's Hospital Boston, Boston, MA, USA (DK).|Hôpital du Sacré-Coeur de Montréal, Montréal, Canada (MN, JH, SL, GYL).|Surgery Department, Université de Montréal, Montreal, Canada (MN, JH, SL, GYL).
Stéphane
S
Leduc
CHU Ste-Justine, Montreal, Québec, Canada (MN, LG).|Children's Hospital Boston, Boston, MA, USA (DK).|Hôpital du Sacré-Coeur de Montréal, Montréal, Canada (MN, JH, SL, GYL).|Surgery Department, Université de Montréal, Montreal, Canada (MN, JH, SL, GYL).
G Yves
GY
Laflamme
CHU Ste-Justine, Montreal, Québec, Canada (MN, LG).|Children's Hospital Boston, Boston, MA, USA (DK).|Hôpital du Sacré-Coeur de Montréal, Montréal, Canada (MN, JH, SL, GYL).|Surgery Department, Université de Montréal, Montreal, Canada (MN, JH, SL, GYL).
Dennis
D
Kramer
D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D000843:Ankle Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D017844:Lateral Ligament, Ankle / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
ankle; high ankle sprain; syndesmosis