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Accuracy of radiographic techniques in detection of the calcaneofibular ligament calcaneal insertion for lateral ankle ligament complex surgery.
Ghasemi, S Ali; Murray, Benjamin C; Lipphardt, Matthew; Yin, Clark; Shaffer, Gene; Raphael, James; Vaupel, Zachary; Fortin, Paul.
Afiliación
  • Ghasemi SA; Department of Orthopaedic Surgery, Albert Einstein Healthcare Network, Philadelphia, PA, USA. einsteinorthoresearch@gmail.com.
  • Murray BC; Naval Medical Center Portsmouth, Portsmouth, VA, USA.
  • Lipphardt M; Royal Oak Beaumont Department of Orthopaedic Surgery, Royal Oak, MI, USA.
  • Yin C; Royal Oak Beaumont Department of Orthopaedic Surgery, Royal Oak, MI, USA.
  • Shaffer G; Department of Orthopaedic Surgery, Albert Einstein Healthcare Network, Philadelphia, PA, USA.
  • Raphael J; Department of Orthopaedic Surgery, Albert Einstein Healthcare Network, Philadelphia, PA, USA.
  • Vaupel Z; Royal Oak Beaumont Department of Orthopaedic Surgery, Royal Oak, MI, USA.
  • Fortin P; Royal Oak Beaumont Department of Orthopaedic Surgery, Royal Oak, MI, USA.
Surg Radiol Anat ; 45(7): 917-922, 2023 Jul.
Article en En | MEDLINE | ID: mdl-37198438
BACKGROUND: Grade III ankle sprains that fail conservative treatment can require surgical management. Anatomic procedures have been shown to properly restore joint mechanics, and precise localization of insertion sites of the lateral ankle complex ligaments can be determined through radiographic techniques. Ideally, radiographic techniques that are easily reproducible intraoperatively will lead to a consistently well-placed CFL reconstruction in lateral ankle ligament surgery. PURPOSE: To determine the most accurate method to locate the calcaneofibular ligament (CFL) insertion radiographically. METHODS: MRIs of 25 ankles were utilized to identify the "true" insertion of the CFL. Distances between the true insertion and three bony landmarks were measured. Three proposed methods (Best, Lopes, and Taser) for determining the CFL insertion were applied to lateral ankle radiographs. X and Y coordinate distances were measured from the insertion found on each proposed method to the three bony landmarks: the most superior point of the postero-superior surface of the calcaneus, the posterior most aspect of the sinus tarsi, and the distal tip of the fibula. X and Y distances were compared to the true insertion found on MRI. All measurements were made using a picture archiving and communication system. The average, standard deviation, minimum, and maximum were obtained. Statistical analysis was performed using repeated measures ANOVA, and a post hoc analysis was performed with the Bonferroni test. RESULTS: The Best and Taser techniques were found to be closest to the true CFL insertion when combining X and Y distances. For distance in the X direction, there was no significant difference between techniques (P = 0.264). For distance in the Y direction, there was a significant difference between techniques (P = 0.015). For distance in the combined XY direction, there was a significant difference between techniques (P = 0.001). The CFL insertion as determined by the Best method was significantly closer to the true insertion compared to the Lopes method in the Y (P = 0.042) and XY (P = 0.004) directions. The CFL insertion as determined by the Taser method was significantly closer to the true insertion compared to the Lopes method in the XY direction (P = 0.017). There was no significant difference between the Best and Taser methods. CONCLUSION: If the Best and Taser techniques can be readily used in the operating room, they would likely prove the most reliable for finding the true CFL insertion.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calcáneo / Ligamentos Laterales del Tobillo / Inestabilidad de la Articulación Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Surg Radiol Anat Asunto de la revista: ANATOMIA / RADIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calcáneo / Ligamentos Laterales del Tobillo / Inestabilidad de la Articulación Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Surg Radiol Anat Asunto de la revista: ANATOMIA / RADIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania