| Objective: Ankle injuries are common in the clinic.Lindsjo et al.found that 5-10% of ankle sprains and 23% of ankle fractures can affect the distal tibiofibular syndesmosis.Bony or ligamentous structures around the ankle can destabilize the ankle.When the ankle joint is damaged,failure to restore the stability of the inferior jaw joint structure will have an adverse effect on the patient’s ankle joint function.At the same time,if misdiagnosis leads to unnecessary surgery,it will increase the risk.These problems have prompted us to fully understand and recognize distal tibiofibular syndesmosis.When patients with combined injuries of the jaw are encountered,we generally prefer the anterior and lateral ankle points.The movement and injury of the sacroiliac joints were judged by observing the joint gap of the lower jaw,the outer edge of the anterior tibia,and the inner margin of the tibia and the medial gap of the ankle joint.However,the sensitivity of the flat X-ray film in detecting the tiny displacement of the ligament is limited,and the change in the position of the projection of the ankle joint has a great influence on the shape of the lower jaw joint.The CT provides an axial view of the jaw joint and has less influence on the change in receptor position during imaging.This clinical study describes the morphological features of the mandible joints in the population of southern Liaoning Province by CT scan technology.It is found that the individual differences in the combined shape of the mandibles and related measurements are large,and helps the clinician to do the imaging features of the ankle injury.Make correct judgments to avoid missed diagnosis or misdiagnosis,and further guide clinical practice.Methods:This study analyzed ankle X-ray and CT images of a total of 145 patients with left ankle fractures who were present in our hospital between January 2015 and January 2018.Including 68 males and 77 females,aged 20-84 years,mean age 47.4±16.1 years old.The relevant data were measured on the CT plane 10 mm above the distal tibial articular surface.Measure the width of the flat and condylar tibia,the width of the iliac indentation,the depth of the tibial condyle,the height of the condylar notch,the radian of the condylar notch,the length of the anterior sacroiliac joint,the length of the posterior sacroiliac joint,and the anterior and posterior sacroiliac joint surfaces.The included angle,frontal space,posterior space,longitudinal length of the distal humerus,lateral length of the distal humerus,and curvature of the medial side of the distal humerus to assess the anatomical and morphological features of the jaw joint.Studies have shown that the distal humerus zygomatic notch can be divided into concave and shallow.When the depth of the crucible not less than 4 mm,the shape of the cricoid notch is considered to be concave,and when the depth of the cristae not less than 4 mm,the shape of the notch is considered to be shallow.Results:In this study,the morphology of the incisura fibularis was concave in 59.6% of cases,and shallow in 40.4%.The mean tibial width was 43.6±3.8 mm.The mean width of the incisura fibularis was 21.1±2.6 mm.The mean depth of the incisura fibularis was 4.2±1.1 mm.The mean height of the incisura fibularis was 22.5±2.9 mm.The mean pericardial curvature was 1.5 ±0.4 rad.The mean length of the anterior facets was 11.0±2.5 mm.The mean length of the posterior facets was 12.0±2.7mm.The mean angle between the anterior and posterior facets was 134.1±17.0 °.The mean distances anterior tibiofibular clearance was 3.7±1.1 mm.The average posterior tibiofibular clearance was 6.3±1.9mm.The average longitudinal length of the distal fibula was 17.8±3.0 mm.The average lateral length of the distal fibula was 13.7±2.0 mm.The average ratio of the longitudinal length of the distal fibula to the transverse length of the fibula was 1.3±0.2.The average curvature of the medial side of the distal fibula was 1.5±0.5 rad.We found a strong correlation between tibial notch depth and tibial width,width of periosteal notch,tibiofibular curvature,anterior and posterior tibiofibular articular surface angle,longitudinal and transverse lengths of distal fibula(p <0.01).The curvature of the medial side of the distal fibula has a strong correlation with the angle of the anterior-posterior tibiofibular articular surface and the depth of the tibial peroneal notch(p <0.01).There was no correlation between the tibiofibular curvature radian and the curvature of the medial side of the distal fibula(p = 0.1).The length of the anterior tibiofibular articular surface and the posterior tibiofibular articular surface had statistical significance(0.01 <p <0.05).There was no significant difference in sex between the anterior and posterior tibiofibular articular surfaces,tibiofibular calcaneal curvature,anterior tibiofibular and posterior tibiofibular and distal fibula medial radii.The tibial width,the width of the peroneal notch,the height of the peroneal notch,the length of the anterior tibiofibular articular surface,the posterior tibiofibular articular surface,the distal longitudinal length of the fibula,the distal transverse width of the fibula and the longitudinal / transverse length were significantly higher than those of the female <0.01).Perforation depth,male than female(p <0.05).There was no significant difference in gender,age,width of tibia,width of periosteum,length of anterior tibiofibular articular surface,anterior tibiofibular,posterior tibiofibular and distal fibula between concave and shallow tibiofibular notch difference.However,the tibial peroneal notch concave and shallow patients in the tibial perforation depth,perforation height,periosteal curvature radian,posterior tibiofibular joint surface length,anterior and posterior tibiofibular articular surface angle,distal fibular longitudinal length,There was a significant difference(p <0.05)between the lateral length of the distal fibula and the longitudinal length / lateral length.Although there was no significant difference in angle between the anterior and posterior tibiofibular articular surfaces between males and females(134.9± 21.5 °in males and 133.4±21.2 °in females),p> 0.05.But we must explain the tibiofibular articular surface angle distribution frequency is different.Conclusions:There is a strong correlation between the squat-associated measurements,so the squat joint can only ensure the normal function of the sacroiliac joint when determining the precise relationship between the distal sacrum and the sacrum.In this study,according to the distal tibial zygomatic notch morphology,the morphological changes of the lower jaw joint of the population in southern Liaoning Province were divided into concave and shallow types.Of these,86 patients(59.6%)had a sacral notch pattern and 59 cases(40.4%).The patient’s zygomatic notch is shallow.When the combined shape of the lower jaw is shallow,the degree of tolerance of the lower jaw combined with the tibia is relatively low,and the X-ray can pass through the gap of the tibia.From the perspective of the DR tab,it appears that the lower jaw is combined and separated.Therefore,there is a widening of the joint width of the lower jaw in the plain film of DR and it cannot diagnose the joint separation of the lower jaw.The CT scan can not be affected by the changes in the position of the ankle.Therefore,intraoperative CT is a more accurate method for diagnosing the inferior hemorrhoids and separating the poorly reset.There is also a correlation between the shape of the distal humerus and the stability of the jaw joint. |
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