MR Imaging Study Of Anatomical Structure Of Normal Distal Tibiofibular Syndesmosis

Background and Purposedistal tibiofibular syndesmosis is important to maintain the structural stability of the ankle joint by former inferior tibiofibular ligament,tibiofibular ligament,transverse tibiofibular ligament,composed between lower tibiofibular ligament four parts.The damage is not as accurate diagnosis and appropriate treatment will seriously affect the stability of the ankle joint,and ultimately lead to chronic ankle dysfunction.In recent years,with the development of sports medicine and ligament reconstruction concept of domestic and foreign scholars tibiofibular stable composite body injury more and more attention.Because MRI has unique advantages in the diagnosis of soft tissue injury,it is now widely used around the ankle ligament injury assessment.However,due to the stable complex course and complex anatomical relationships,about the MRI scan using three conventional orthogonal planes(axial,coronal,sagittal)were observed tibiofibular stable complex injury research and comparative case surgery when found,since the ligament Traveling with orthogonal planes is not entirely consistent with conventional scanning planes may cause ligament injury false positives and false negatives exist,and therefore does not fully meet the needs of clinical diagnosis.Given the current stable on MRI next tibiofibular complex injury on display a complete solution has not yet formed.Therefore,the present study is to investigate the stability of MRI different angles composite display,to find the best show of the structure scanning solution for clinical use.Materials and methods(1)select 13 cases to meet the requirements of adult ankle specimens(no trauma,deformity,no significant joint disease),seven cases of the left and right side in 6 cases,gender,age unknown;dissected and separated the four ligaments(AITFL、PITFL、ITL、IOL),carefully observe the start and end points of various ligaments,out of shape direction.(2 exposure along the ligament fibers to mark metal needle,make it consistent with the long axis of the ligament,and intake lateral X-rays of the ligament and the long axis of the tibial shaft angle measurement on X-ray film;.Interosseous ligaments due to mark needle difficult to fix,and take measure of the long axis of the ligament tibial long axis angle specimens.(3)the development of the scanning program according to the measured angle of 40 normal volunteers(no history of ankle sprain,deformity,joint symptoms,etc.)SE TIWI a row scanning,including scanning azimuth plane and the conventional three different angles of oblique planes.observe and compare the different scanning position for the stability display complex.Results(1)found that the gross anatomy: anterior tibiofibular ligament starting from the top of the distal tibial tuberosity and out the bottom front oblique and proximal ends of the distal fibula anterior tubercle of the ligament in the middle thicker,to the next gradually become thin;tibiofibular ligament after starting in distal tibial tubercle after ankle,fibula fibula distal ends after nodules,cord-like in shape,uniform thickness;interosseous ligament from the distal end of the tibia side from the top of the ankle about 5 cm ~ 6 cm place.Outward migration downward beyond the distal medial fibula.Transverse inferior tibiofibular ligament,located below the rear lower tibiofibular ligament,starting in the distal fibula after nodules level courses,beyond the edges of the dorsal distal tibial ankle.(2)X ray measurement results: anteroposterior stability of the composite average angle are AITFL: 41.65 °,PITFL 56.74 ° ITL 72.05 °;IOL: 20.68 °.The average angle radiographs were AITFL: 21.60 °,PITFL30.73 ° ITL 65.42 °.(3)MRI scanning angle is determined: in AITFL different angles of scanning orientation,+ 20 ° and 45 ° oblique coronal oblique sagittal look best;PITFL55 ° oblique sagittal and axial look best;ITL15 ° oblique transverse position works best,followed by-65 ° oblique coronal.IOL coronal show the best,followed by 20 ° oblique sagittalConclusionBy selecting a certain angle miter bit MRI imaging can clearly show stability in all tibiofibular ligament complex,and as an effective method for the diagnosis of stable complex injury.