TY - JOUR
T1 - Measuring External Rotation of the Fibula and Fibular Length in Bilateral Computed Tomography Scans
T2 - How Reliable Is This Method?
AU - Penning, Diederick
AU - Molendijk, Juul
AU - Halm, Jens A.
AU - Schepers, Tim
N1 - Publisher Copyright: © 2024 Wolters Kluwer Health. All rights reserved.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - OBJECTIVES:During ankle fracture surgery, goals include accurate reduction and fixation of the fibula regarding rotation and fibular length. Bilateral postoperative computed tomography (CT) can be performed to assess fibular rotation using the talar dome angle, and fibular length. The aim of this study was to compare side-to-side differences of the fibular rotation and fibular length using bilateral CT scans of uninjured ankles.METHODS:Design:Retrospective.Setting:Single center, Level I Academic Trauma Center.Patient Selection Criteria:Patients with bilateral CT scans of uninjured ankles.Outcome Measures and Comparisons:External rotation using the Nault talar dome method and fibular length using the coronal method of Prior etal. The average, difference, and ratio (injured side/healthy side) and interobserver variability were calculated.RESULTS:There were 83 patients included (166 ankles, mean age 47 years, 77.1% male). A random set of 66 ankles (33 CT scans) were used to measure interobserver variability. The mean degrees of external rotation ranged from 6.6 to 7.7, mean difference ranged from 1.4 to 3.4 degrees, mean ratio ranged from 1.1 to 1.5, and interobserver variability ranged from 0.27 to 0.65. For fibular length, the mean ranged from 24.6 to 25.8 mm, mean difference in fibular length ranged from 0.5 to 2.1 mm, mean ratio ranged from 1.0 to 1.1 mm, and interobserver variability ranged from 0.45 to 0.73.CONCLUSIONS:Using bilateral ankle CT scans, mean differences in fibular rotation using the Nault talar dome method were 1.4-3.4 degrees. The distal fibular length had a mean difference between both sides of 0.5-2.1 mm. Although the intraclass correlation's were low, the interleg differences between patients were small, making them useful for clinical practice.LEVEL OF EVIDENCE:Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
AB - OBJECTIVES:During ankle fracture surgery, goals include accurate reduction and fixation of the fibula regarding rotation and fibular length. Bilateral postoperative computed tomography (CT) can be performed to assess fibular rotation using the talar dome angle, and fibular length. The aim of this study was to compare side-to-side differences of the fibular rotation and fibular length using bilateral CT scans of uninjured ankles.METHODS:Design:Retrospective.Setting:Single center, Level I Academic Trauma Center.Patient Selection Criteria:Patients with bilateral CT scans of uninjured ankles.Outcome Measures and Comparisons:External rotation using the Nault talar dome method and fibular length using the coronal method of Prior etal. The average, difference, and ratio (injured side/healthy side) and interobserver variability were calculated.RESULTS:There were 83 patients included (166 ankles, mean age 47 years, 77.1% male). A random set of 66 ankles (33 CT scans) were used to measure interobserver variability. The mean degrees of external rotation ranged from 6.6 to 7.7, mean difference ranged from 1.4 to 3.4 degrees, mean ratio ranged from 1.1 to 1.5, and interobserver variability ranged from 0.27 to 0.65. For fibular length, the mean ranged from 24.6 to 25.8 mm, mean difference in fibular length ranged from 0.5 to 2.1 mm, mean ratio ranged from 1.0 to 1.1 mm, and interobserver variability ranged from 0.45 to 0.73.CONCLUSIONS:Using bilateral ankle CT scans, mean differences in fibular rotation using the Nault talar dome method were 1.4-3.4 degrees. The distal fibular length had a mean difference between both sides of 0.5-2.1 mm. Although the intraclass correlation's were low, the interleg differences between patients were small, making them useful for clinical practice.LEVEL OF EVIDENCE:Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
KW - CT scan measurements
KW - Syndesmosis
KW - fibular length
KW - fibular rotation
KW - normal values
UR - http://www.scopus.com/inward/record.url?scp=85188480020&partnerID=8YFLogxK
U2 - 10.1097/BOT.0000000000002774
DO - 10.1097/BOT.0000000000002774
M3 - Article
C2 - 38306014
SN - 0890-5339
VL - 38
SP - 205
EP - 209
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
IS - 4
ER -