Ins and Outs of the Ankle Syndesmosis from a 2D to 3D CT Perspective

Despite various proposed measurement techniques for assessing syndesmosis integrity, a standardized protocol is lacking, and the existing literature reports inconsistent findings regarding normal abnormal relationships between fibula tibia at distal level. Therefore, this study aims to present an overview of two- (2D) three-dimensional (3D) methods utilized evaluate integrity. A topical review was conducted, including studies employing 2D or 3D quantify tibiofibular alignment on computed tomography (CT) weight-bearing CT (WBCT) scans. total 49 eligible articles were included in review. While most interclass correlation (ICC) values indicate favorable reliability, certain measurements involving multiple steps exhibited lower ICC values, potentially due learning curve associated with their implementation. Inconclusive results obtained influence age, sex, height syndesmotic measurements. No significant difference observed bilateral ankles, permitting use opposite side as internal control comparison. There notable range pathological evidenced by standard deviation each measurement. This highlights absence consensus integrity despite numerous scan studies. The diverse techniques, complexity, inconclusive challenges distinguishing routine clinical practice. Promising advancements novel offer potential automated reduction observer inaccuracies, but further validation needed.