Reliability of distal tibio-fibular syndesmotic instability measurements using weightbearing and non-weightbearing cone-beam CT. Issue 6 (December 2019)

• Record Type: Journal Article
• Authors: Osgood, Greg M.; Shakoor, Delaram; Orapin, Jakrapong; Qin, Jianzhong; Khodarahmi, Iman; Thawait, Gaurav K.; Ficke, James R.; Schon, Lew C.; Demehri, Shadpour
• Is Part Of: Foot and ankle surgery. Volume 25:Issue 6(2019)
• Page Start: 771
• Page End: 781
• Publication Date: 2019-12
• Subjects: ATFD anterior tibio-fibular distance -- CBCT cone-beam computed tomography -- CT computed tomography -- ICC intra-class correlation coefficient -- LCS lateral clear space -- MCS medial clear space -- MRI magnetic resonance imaging -- NWB non-weightbearing -- PTFD posterior tibio-fibular distance -- TFCS tibio-fibular clear space -- LI tibial incisura length line -- WB weightbearing; Syndesmotic injury -- Weightbearing -- Cone-beam computed tomography -- Non-weightbearing; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2018.10.003
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: Syndesmotic measurements on weight bearing CT are feasible and reproducible. High level of agreement was observed between 3 independent readers. These measurements should be compared to normal side to determine syndesmosis integrity. Abstract: Background: To investigate the reliability and reproducibility of syndesmosis measurements on weightbearing (WB) cone-beam computed tomography (CBCT) images and compare them with measurements obtained using non-weightbearing (NWB) images. Methods: In this IRB-approved, retrospective study of 5 men and 9 women with prior ankle injuries, simultaneous WB and NWB CBCT scans were taken. A set of 21 syndesmosis measurements using WB and NWB images were performed by 3 independent observers. Pearson/Spearman correlation and intra-class correlation (ICC) were used to assess intra- and inter-observer reliability, respectively. Results: We observed substantial to perfect intra-observer reliability (ICC = 0.72–0.99) in 20 measurements. Moderate to perfect agreement (ICC = 0.45–0.97) between observers was noted in 19 measurements. Conclusion: Measurements evaluating the distance between tibia and fibula in the axial plane 10 mm above the plafond had high intra- and inter-observer reliability. Mean posterior tibio-fibular distance, diastasis, and angular measurement were significantly different between WB and NWB images.