대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제8권1호
  • /
  • Pages.1-6
  • /
  • 2004
  • /
  • 1738-3757(pISSN)
  • /
  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
권호 표지

족관절 원위 경비 인대 결합의 급성 파열에 대한 초음파 검사의 진단적 의의

Diagnostic Value of Ultrasonography for Acute Tear of Tibiofibular Syndesmosis in Ankle

  • 이호승 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 박수성 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 김지완 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 신명진 (울산대학교 의과대학 서울아산병원 방사선과학교실) ;
  • 김성문 (울산대학교 의과대학 서울아산병원 방사선과학교실) ;
  • 이상훈 (울산대학교 의과대학 서울아산병원 방사선과학교실) ;
  • 이상민 (울산대학교 의과대학 서울아산병원 방사선과학교실)
  • Lee, Ho-Seung (Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Park, Soo-Sung (Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Ji-Wan (Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Shin, Myung-Jin (Department of Radiology, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Sung-Moon (Department of Radiology, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Lee, Sang-Hoon (Department of Radiology, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Lee, Sang-Min (Department of Radiology, Asan Medical Center, College of Medicine, Ulsan University)
  • 발행 : 2004.06.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: We studied the diagnostic value of ultrasonography to confirm the presence of the syndesmosis injuries in the ankle. Materials and Methods: Pre-operative ultrasonography were taken in 42 cases of ankle fractures to determine injury of syndesmosis between February 2000 and August 2003. Tear of syndesmosis was confirmed when they met the following criteria; widening of distal tibiofibular clear space greater than 7 mm on pre-operative AP X-rays, leakage of contrast dye during intra-operative arthrography, and operative findings revealing syndesmosis rupture. We compared these diagnoses with those made by pre-operative ultrasonography. Results: Syndesmosis injuries were confirmed in 23 cases among the total 42 cases. Ultrasonography revealed syndesmosis tear in 25 cases, with 20 cases corresponding with confirmed tear and 5 cases without tear in confirm. Syndesmoses were found to be intact in 17 cases of ultrasonograph, but 3 cases were actually confirmed tear. In ankle ultrasonography, the sensitivity was 90.9%, the specificity was 75.0%. Conclusion: Preoperative ultrasonography is a non-invasive and useful study to determine the syndesmosis injury in ankle fractures.

키워드

참고문헌

  1. Bonnin JG: Injuries to the ankle, Darien, Conn, Hafner:147-185, 1970.
  2. Brostroem L, Liljedahl SO and Lindvall N: Sprained ankles.Ⅱ . Arthrographic diagnosis of recent ligament ruptures, Acta Chir Scand, 129: 485-499, 1965.
  3. Burns WC II, Prakash K, Adelaar R, Beaudoin A and Krause W: Tibiotalar joint dynamics: indications for syndesmotic screw: a cadaver study. Foot Ankle, 14: 153-158, 1993. https://doi.org/10.1177/107110079301400308
  4. Close JR: Some applications of the functional anatomy of the ankle joint. J Bone Joint Surg, 69-A: 596-604, 1987. https://doi.org/10.2106/00004623-198769040-00017
  5. Garbarino JL, Clancy M, Harcke HT, et al.: Congenital diastasis of the inferior tibiofibular joint: a review of the literature and report of two cases. J Pediatr Orthop, 5: 225-228, 1985. https://doi.org/10.1097/01241398-198505020-00021
  6. Grath GB: Widening of the ankle mortise: A clinical and experimental study. Acta Chir Scand. suppl, 263: 1-88, 1960.
  7. Harper MC and Keller TS: A radiographic evaluation of the tibiofibular syndesmosis. Foot Ankle, 10: 156-160,1989. https://doi.org/10.1177/107110078901000308
  8. Jaas MH: Clinical significance of magnetic resonance imaging of the ankle and foot. Magn Reson Imaging Clin North Am, 2: 29-38, 1994.
  9. Joy G, Patzakis MJ and Harvey JP: Precise evaluation of the reduction of severe ankle fractures: Technique and correlation with end results. J Bone Joint Surg, 56-A: 979-993, 1974. https://doi.org/10.2106/00004623-197456050-00010
  10. Katznelson A, Lin E and Militiano J: Ruptures of the ligaments about the tibio-fibular syndesmosis. Injury, 15: 170-172, 1983. https://doi.org/10.1016/0020-1383(83)90007-4
  11. Kerr R, Forrester DM and Kingston S: Magnetic resonance imaging of foot and ankle trauma. Orthop Clin North Am, 21: 591-601, 1990.
  12. Lauge-Hansen N: Fractures of the ankle: II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg, 60: 957-985, 1950
  13. Leeds HC and Ehrlich MG: Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures. J Bone Joint Surg, 66-A: 490-503, 1984. https://doi.org/10.2106/00004623-198466040-00002
  14. Milz P, Milz S, Steinborn M, Mittlmeier T, Putz R and Reiser M: Lateral ankle and ligaments and tibiofibular syndesmosis. 13-MHz high-frequency sonography and MRI compared in 20 patients. 69(1): 51-55, 1998. https://doi.org/10.3109/17453679809002357
  15. Oglivie-Harris DJ, Reed SC and Hdemn TP: Disruption of the ankle syndesmosis: biomechanical study of the ligamentous restraints. Arthroscopy, 10: 558-560, 1994. https://doi.org/10.1016/S0749-8063(05)80014-3
  16. Oglivie-Harris DJ and Reed SC: Disruption of the ankle syndesmosis: Diagnosis and treatment by arthroscopic surgery. Arthroscopy, 10: 561-568, 1994. https://doi.org/10.1016/S0749-8063(05)80015-5
  17. Ostrum RF, De Meo P and Subramanian R: A critical analysis of the anterior-posterior radiographic anatomy of the ankle syndesmosis. Foot Ankle int, 16: 128-131, 1995. https://doi.org/10.1177/107110079501600304
  18. Pettrone FA, Gail M, Pee D, Fitzpatrick T and Van Herpe LB: Quantitative criteria for prediction of the results after displaced fracture of the ankle. J Bone Joint Surg, 65-A: 667-677, 1983.
  19. Ramsey PL and Hamilton W: Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg, 58-A: 356-357, 1976.
  20. Rasmussen O: Stability of the ankle joint. Analysis of the function and traumatology of the ankle ligaments. Acta Orthop Scand, Suppl, 211, 1985.
  21. Mann RA and Coughlim MJ: Surgery of the foot and ankle. 6th ed. St. Louis, Mosby-Year Book Inc: 1148, 1993.
  22. Sarkisian JS and Cody GW: Closed treatment of ankle fractures; A new criteria for evaluation-A review of 250 cases. J Trauma, 16: 323-326, 1976. https://doi.org/10.1097/00005373-197604000-00014
  23. Sclafani SJ: Ligamentous injury of the lower tibiofibular syndesmosis: radiopgraphic evidence. Radiology, 156: 21-27, 1985. https://doi.org/10.1148/radiology.156.1.4001407
  24. Steinbronn DJ, Bennett GL and Kay DB: The use of magnetic resonance imaging in the diagnosis of stress fractures of the foot and ankle:four case reports. Foot Ankle Int, 15: 80-83, 1994. https://doi.org/10.1177/107110079401500206
  25. Takao M, Ochi M, Naito K, et al.: Arthroscopic diagnosis of tibiofibular syndesmosis disruption. Arthroscopy, 17: 836-843, 2001. https://doi.org/10.1016/S0749-8063(01)90007-6
  26. Takao M, Ochi M, Oae K, Naito K and Uchio Y: Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle. J Bone Joint Surg, 85-B: 324-329, 2003. https://doi.org/10.1302/0301-620X.85B3.13174
  27. Vogl TJ, Hochmuth K, Diebold T, et al.: Magnetic resonance imaging in the diagnosis of acute injured distal tibiofibular syndesmosis. Invest Radio, 32: 401-409, 1997. https://doi.org/10.1097/00004424-199707000-00006
  28. Woolson ST, Dev P, Fellingham LL, et al.: Threedimensional imaging of the ankle joint from computerized tomography. Foot Ankle, 6: 2-6, 1985. https://doi.org/10.1177/107110078500600102
  29. Xenos JS, Hopkinson WJ, Mulligan ME, et al.: The tibiofibular syndesmosis: Evaluation of the ligamentous structures, methods of fixation, and radiolographic assessment. J Bone Joint Surg, 77-A: 847-856, 1995. https://doi.org/10.2106/00004623-199506000-00005