Ideal angle of syndesmotic screw fixation: A CT-based cross-sectional image analysis study

Young Hwan Park, Won Seok Choi, Gi Won Choi, Hak Jun Kim

    Research output: Contribution to journalArticlepeer-review

    11 Citations (Scopus)

    Abstract

    Without clear reference, the precision of syndesmotic screw placement cannot be guaranteed and malposition of these screws leads to poor results. Therefore, to prevent malpositioning of syndesmotic screws, an improved understanding of the orientation of tibiofibular syndesmosis is essential. We analyzed cross-sectional computed tomography (CT) scans of the foot and ankle to identify precise screw positions for the treatment of syndesmotic injuries. A total of 134 calcaneal fractures with intact tibiofibular syndesmosis were enrolled in this retrospective study. We measured the angle between the perpendicular line of the second proximal phalanx and the line start apex of the lateral cortex of the fibula bisecting the tibial incisura and crossing the center of the tibia in neutral ankle joints, with the second toe positioned anteriorly using a short leg splint. The second toe was used as the reference for clarity and applicability. The ideal angle of syndesmotic screw placement in cross-sectional CT images was 18.8 ± 5.6° (mean ± standard deviation) and did not differ according to independent variables (P > 0.05). In neutral ankle joints with the second toe positioned anteriorly, the ideal angle of syndesmotic screw placement is 18.8°, which is less than that currently in used in conventional methods.

    Original languageEnglish
    Pages (from-to)2602-2605
    Number of pages4
    JournalInjury
    Volume48
    Issue number11
    DOIs
    Publication statusPublished - 2017 Nov 1

    Keywords

    • Ankle syndesmosis
    • Computed tomography
    • Ideal angle
    • Syndesmotic screw fixation

    ASJC Scopus subject areas

    • Emergency Medicine
    • Orthopedics and Sports Medicine

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