Evaluative Study Of Diagnosis Value Of CT Tibiofibular Line In Syndesmosis Malposition

purposeAs our country promotes the development of a healthy and beautiful life,the number of people who love sports activities in our country increases year by year,and ankle sprain often occurs in sports activities.As a result,ankle fractures are becoming more common,with consequent syndesmosis injuries.Tibiofibular syndesmosis without proper treatment can lead to complications such as ankle instability,pain and traumatic arthritis in the late stage of acute injury,increasing the risk of secondary surgery and medical expenses.In addition to determine whether the need for surgical treatment.How to screen for the diagnosis of acute injury patients,but also the key to the treatment of ankle injury.Currently used diagnostic X-ray diagnosis,but low sensitivity,specificity and other shortcomings.Although CT is more suitable for the diagnosis of syndesmosis injury,but the lack of uniform and easy to measure the diagnostic criteria.Therefore,the purpose of this study is to obtain a simple and reliable CT diagnostic criteria to judge whether there is syndesmosis injury by comparing the traditional diagnostic criteria and new standards in the intraoperative clear identification of patients with tibiofibular syndesmosis injury,to guide clinical application.methodThrough retrospective analysis of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from January 2012 to June2017,over the age of 20,diagnosed with "ankle fracture",with or without "syndesmosis injury" "tibiofibular Anterior ligament rupture," " Tibiofibular ligament injury," and in our hospital an orthopedic surgery patients.The tibiofemoral space,tibiofemoral fold and CT tibiofibular line were measured.The data were recorded by EXCEL and analyzed by SPSS 22.0 software.First statistical analysis of tibiofiban accuracy and applicability,and then through the ROC curve to select the best range.resultA total of 61 cases of ankle fractures surgically treated in our hospital were collected.Among them,32 cases were simple ankle fracture,29 cases were ankle fracture combined with tibiofibular syndesmosis.There was no significant difference in gender and fracture type between the two groups(P>0.05).The age of the two groups was significantly higher in the non-injured group(62.18±16.65)than in the injured group(43.46±14.37),with significant difference(P <0.05).The tibiofibular line values of the two groups of patients can not meet the normal distribution at the same time.The tibiofibular line values of the non-injured group are non-normal distribution.There was no significant correlation between tibiofibular line and age(P>0.05).The tibiofibular values of the two groups were significantly lower than those of the injured group(1.44±1.40 vs 3.84±2.33,P <0.05).The ROC curve of the tibiofibular and tibiofibular syndesmotic lesions was drawn.The area under the curve was 0.817,and the prediction was significant(P <0.05).According to the sensitivity and specificity plus or minus one for the maximum Youden index and the best working point,the tibiofibular value of the best working point was 2.1mm,the predicted sensitivity was 81.3%,the specificity was 86.6%,Youden The value is 68.7%.According to the case of traditional X-ray indicators to judge,the prediction sensitivity was 68.7%,specificity was 73.3%,Youden value was 42.0%.conclusionAccording to this study,the tibiofibular line value is a simple,reliable,and easily measurable measure of syndesmosis injury that has no significant association with age,ie,the likelihood of variation due to age to the tibiofibular line less.For its best working point(taking tibiofibular line value> 2.1mm)predicts whether the fracture combined with tibiofibular syndesmosis injury than the traditional X-ray indicators of its sensitivity and specificity are higher.However,due to the insufficient number of included samples,its universality and reliability still need to be analyzed by more large sample data in the future.It is recommended to use the tibiofibular line as a supplement to the traditional X-ray indicators,combined with the comprehensive evaluation of history,signs,clinical examination and so on to carry out early diagnosis and guide the clinical treatment.