Anatomical study on the distal tibiofibular syndesmosis based on CT images

ZHAO Hong-xian; GAO Shi-chang; WANG Zi-jia; YANG Ming-ming

doi:10.11659/jjssx.04E025018

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Anatomical study on the distal tibiofibular syndesmosis based on CT images

Clinical Research | 更新时间：2025-12-22

- Anatomical study on the distal tibiofibular syndesmosis based on CT images
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 12, Pages: 1087-1090(2025)
- 作者机构：
  
  重庆医科大学附属第一医院骨科/重庆医科大学骨科实验室，重庆 400042
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.04E025018
  CLC： R683.42
- Received：02 April 2025，
  
  Published：25 December 2025
- 稿件说明：
移动端阅览
赵鸿鲜,高仕长,汪子嘉等.基于CT图像的下胫腓联合解剖学研究[J].局解手术学杂志,2025,34(12):1087-1090.

ZHAO Hong-xian,GAO Shi-chang,WANG Zi-jia,et al.Anatomical study on the distal tibiofibular syndesmosis based on CT images[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1087-1090.
赵鸿鲜,高仕长,汪子嘉等.基于CT图像的下胫腓联合解剖学研究[J].局解手术学杂志,2025,34(12):1087-1090. DOI： 10.11659/jjssx.04E025018.

ZHAO Hong-xian,GAO Shi-chang,WANG Zi-jia,et al.Anatomical study on the distal tibiofibular syndesmosis based on CT images[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1087-1090. DOI： 10.11659/jjssx.04E025018.

摘要

目的

基于CT图像量化分析正常踝关节下胫腓联合解剖参数，为临床诊断下胫腓联合损伤、精准复位及螺钉置入提供影像学依据。

方法

回顾性分析我院200例（男女各100例）正常踝关节CT扫描数据，应用Mimics三维重建系统测量以下参数：下胫腓前距离、下胫腓后距离、腓骨前/后缘与腓切迹中点垂距比值、内外踝高度差、内外踝角度、下胫腓关节面高度、距胫骨远端关节面2 cm和4 cm处下胫腓角度。

结果

下胫腓后距离显著大于下胫腓前距离（

0.05），但二者在性别间差异无统计学意义（

0.05）。腓骨前/后缘与腓切迹中点垂距比值、内外踝高度差、内外踝角度及下胫腓关节面高度等参数在不同性别间无显著差异（

0.05）。距胫骨远端关节面4 cm处下胫腓角度较2 cm处增大（

0.05）。

结论

单纯以下胫腓前后距离差>2 mm作为下胫腓联合损伤的诊断标准可能导致假阴性，需联合腓骨前/后缘与腓切迹中点垂距比值异常（>1.58或<1.47）综合判断；术后可在不考虑性别因素下通过测量内外踝高度差与角度来评估外踝的长度是否恢复；下胫腓螺钉安全置入区应位于胫骨远端关节面近端16 mm以上，前倾角度需根据置入平面调整。

Abstract

Objective

To perform a quantitative analysis on the anatomic parameters of distal tibiofibular syndesmosis in normal ankle joints based on CT images， thereby providing imaging basis for the clinical diagnosis of distal tibiofibular syndesmosis injury， accurate reduction and screw placement.

Methods

The CT scan data of 200 normal ankle joints （100 males and 100 females） were retrospectively analyzed. The Mimics 3D reconstruction system was used to measure the following parameters： anterior distal tibiofibular distance， posterior distal tibiofibular distance， ratio of the vertical distances between anterior/posterior margin of fibula to midpoint of fibular notch， height difference of medial and lateral malleolus， angle of medial and lateral malleolus， height of distal tibiofibular articular surface， and the distal tibiofibular angles at 2 cm and 4 cm from the distal tibial surface.

Results

The posterior distal tibiofibular distance was significantly greater than the anterior distal tibiofibular distance （

0.05）， while no statistically significant difference was found in these two parameters between genders （

0.05）. There was no statistically significant difference in the ratio of the vertical distances between anterior/posterior margin of fibula to midpoint of fibular notch， height difference of medial and lateral malleolus， angle of medial and lateral malleolus or height of distal tibiofibular articular surface between genders （

0.05）. The distal tibiofibular angle at 4 cm from the distal tibial surface was greater than that at 2 cm （

0.05）.

Conclusion

Using a distal tibiofibular anterior-posterior distance difference greater than 2 mm as the sole diagnostic criterion for distal tibiofibular syndesmosis injury may result in false-negative diagnoses， and it is necessary to combine this criterion with an abnormal ratio of the vertical distances between anterior/posterior margin of fibula to midpoint of fibular notch （>1.58 or <1.47） for comprehensive diagnosis. The restoration of lateral malleolar length after surgery can be evaluated by measuring the height difference and angle of medial and lateral malleolus without considering gender factors. The safe zone for distal tibiofibular screw placement should be located more than 16 mm from the distal tibial joint surface， and the anteversion angle should be adjusted according to the placement plane.

关键词

Keywords

references

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