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Reliability of distal tibio-fibular syndesmotic instability measurements using weightbearing and non-weightbearing cone-beam CT.

Authors
  • Osgood, Greg M1
  • Shakoor, Delaram2
  • Orapin, Jakrapong3
  • Qin, Jianzhong4
  • Khodarahmi, Iman5
  • Thawait, Gaurav K5
  • Ficke, James R1
  • Schon, Lew C6
  • Demehri, Shadpour5
  • 1 Department of orthopedic surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • 2 Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: [email protected]
  • 3 Department of Foot and Ankle Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA; Department of Orthopedic Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. , (Thailand)
  • 4 Department of Foot and Ankle Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA; Department of Orthopedic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China. , (China)
  • 5 Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • 6 Department of Foot and Ankle Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Type
Published Article
Journal
Foot and Ankle Surgery
Publisher
Elsevier
Publication Date
Dec 01, 2019
Volume
25
Issue
6
Pages
771–781
Identifiers
DOI: 10.1016/j.fas.2018.10.003
PMID: 30442425
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To investigate the reliability and reproducibility of syndesmosis measurements on weightbearing (WB) cone-beam computed tomography (CBCT) images and compare them with measurements obtained using non-weightbearing (NWB) images. In this IRB-approved, retrospective study of 5 men and 9 women with prior ankle injuries, simultaneous WB and NWB CBCT scans were taken. A set of 21 syndesmosis measurements using WB and NWB images were performed by 3 independent observers. Pearson/Spearman correlation and intra-class correlation (ICC) were used to assess intra- and inter-observer reliability, respectively. We observed substantial to perfect intra-observer reliability (ICC=0.72-0.99) in 20 measurements. Moderate to perfect agreement (ICC=0.45-0.97) between observers was noted in 19 measurements. Measurements evaluating the distance between tibia and fibula in the axial plane 10mm above the plafond had high intra- and inter-observer reliability. Mean posterior tibio-fibular distance, diastasis, and angular measurement were significantly different between WB and NWB images. Copyright © 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

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