Next Tibiofibular Joint Volume And Lower Tibiofibular Syndesmosis Injury Research

Objective:To evaluate the diagnostic value of tibiofibular syndesmosis volume for the tibiofibular syndesmosis injury, initially identified the tibiofibular syndesmosis volume to diagnose the critical point of the tibiofibular syndesmosis injury diagnosis, preparing the new reference standard for the diagnosis.Methods:Collected 47 cases hospitalized patients, with surgical indication closed ankle fractures, in department of orthopaedics, Guang An Men Hospital, China Academy of Chinese Medical Sciences, from June 2010 to March 2011 period. All the patients were taken open reduction and internal fixation, exploring the tibiofibular syndesmosis in the operation, and take the results of the exploration as the gold standard of diagnosing tibiofibular syndesmosis injury, in the research diagnosis. All the patients had routine preoperative CT scan plus reconstruction of double ankles, measure d and calculated the volume tibiofibular syndesmosis percentage change of the injured side compared with the healthy side, the results were compared with the results of surgical exploration. Then draw ROC curve with SPSS software, to evaluate the diagnostic value and obtained the critical point of diagnosis. And we compared the changes of the volume of tibiofibular syndesmosis with ankle fracture of Denis-Weber type to determine the correlation between them.Results:24 patients had the presence of tibiofibular syndesmosis injury of the total 47 ankle fracture patients in the study. Drew the ROC curve, area under the curve A=0.918. We took the tangent point of slope rate 45°, the corresponding critical point of diagnosis was 47.5%. According to the critical point of diagnosis, the diagnostic sensitivity of volume change of tibiofibular syndesmosis for tibiofibular syndesmosis injury was 91.7%, specificity was 78.3%, positive likelihood ratio was 4.36, negative likelihood ratio was 0.10, Youden index was 0.7. Spearman correlation coefficient of volume change of tibiofibular syndesmosis with Denis-Weber type was 0.458, there was statistical significance (P≤0.05). It can be considered that the two had correlations.Concultion:Volume change of tibiofibular syndesmosis has a high diagnostic value for clinical diagnosis of tibiofibular syndesmosis injury, it can provide a new reference index for clinical diagnosis of tibiofibular syndesmosis injury, and the effective guidance for clinical treatment.