TY - JOUR
T1 - Ins and Outs of the Ankle Syndesmosis from a 2D to 3D CT Perspective
AU - Dhont, Thibaut
AU - Huyghe, Manu
AU - Peiffer, Matthias
AU - Hagemeijer, Noortje
AU - Karaismailoglu, Bedri
AU - Krahenbuhl, Nicola
AU - Audenaert, Emmanuel
AU - Burssens, Arne
N1 - Publisher Copyright: © 2023 by the authors.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Despite various proposed measurement techniques for assessing syndesmosis integrity, a standardized protocol is lacking, and the existing literature reports inconsistent findings regarding normal and abnormal relationships between the fibula and tibia at the distal level. Therefore, this study aims to present an overview of two- (2D) and three-dimensional (3D) measurement methods utilized to evaluate syndesmosis integrity. A topical literature review was conducted, including studies employing 2D or 3D measurement techniques to quantify distal tibiofibular syndesmosis alignment on computed tomography (CT) or weight-bearing CT (WBCT) scans. A total of 49 eligible articles were included in this review. While most interclass correlation (ICC) values indicate favorable reliability, certain measurements involving multiple steps exhibited lower ICC values, potentially due to the learning curve associated with their implementation. Inconclusive results were obtained regarding the influence of age, sex, and height on syndesmotic measurements. No significant difference was observed between bilateral ankles, permitting the use of the opposite side as an internal control for comparison. There is a notable range of normal and pathological values, as evidenced by the standard deviation associated with each measurement. This review highlights the absence of a consensus on syndesmotic measurements for assessing integrity despite numerous CT scan studies. The diverse measurement techniques, complexity, and inconclusive findings present challenges in distinguishing between normal and pathological values in routine clinical practice. Promising advancements in novel 3D techniques offer potential for automated measurements and reduction of observer inaccuracies, but further validation is needed.
AB - Despite various proposed measurement techniques for assessing syndesmosis integrity, a standardized protocol is lacking, and the existing literature reports inconsistent findings regarding normal and abnormal relationships between the fibula and tibia at the distal level. Therefore, this study aims to present an overview of two- (2D) and three-dimensional (3D) measurement methods utilized to evaluate syndesmosis integrity. A topical literature review was conducted, including studies employing 2D or 3D measurement techniques to quantify distal tibiofibular syndesmosis alignment on computed tomography (CT) or weight-bearing CT (WBCT) scans. A total of 49 eligible articles were included in this review. While most interclass correlation (ICC) values indicate favorable reliability, certain measurements involving multiple steps exhibited lower ICC values, potentially due to the learning curve associated with their implementation. Inconclusive results were obtained regarding the influence of age, sex, and height on syndesmotic measurements. No significant difference was observed between bilateral ankles, permitting the use of the opposite side as an internal control for comparison. There is a notable range of normal and pathological values, as evidenced by the standard deviation associated with each measurement. This review highlights the absence of a consensus on syndesmotic measurements for assessing integrity despite numerous CT scan studies. The diverse measurement techniques, complexity, and inconclusive findings present challenges in distinguishing between normal and pathological values in routine clinical practice. Promising advancements in novel 3D techniques offer potential for automated measurements and reduction of observer inaccuracies, but further validation is needed.
KW - 2D measurements
KW - 3D modelling
KW - ankle syndesmosis
KW - sport injuries
KW - weightbearing CT
UR - http://www.scopus.com/inward/record.url?scp=85174202896&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/app131910624
DO - https://doi.org/10.3390/app131910624
M3 - Review article
SN - 2076-3417
VL - 13
JO - Applied Sciences (Switzerland)
JF - Applied Sciences (Switzerland)
IS - 19
M1 - 10624
ER -