Understanding the superior clear space in the adult ankle
Understanding the superior clear space in the adult ankle
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DOI：
10.3113/fai.2007.0490
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发表时间：
2007-04-01
影响因子：
2.7
通讯作者：
DeAngelis, Nicola A.
中科院分区：
文献类型：
--
作者：
DeAngelis, Joseph P.;Anderson, Richard;DeAngelis, Nicola A.
背景：内侧间隙的宽度通常被用来确定三角肌韧带的完整性，三角肌韧带是踝关节的主要内侧稳定器。上间隙与内侧间隙的正常临床关系没有得到很好的描述。这项调查试图确定上位间隙是否构成内侧间隙的准确比较点，以及评估成人踝关节韧带稳定性的方法。方法：使用基于大学的放射学数据库，对连续4个月的踝关节X线片进行了回顾。使用一把数字校准的尺子，在插槽面上测量内侧和上侧间隙的宽度。使用学生t检验对这些值进行比较。结果：回顾了564例连续踝关节的数字化X线片，其中94例无创伤、手术或退行性疾病的证据。内、上间隙分别为2.7 mm(标准差0.5；范围1.3~4.3 mm；95%可信区间1.7 mm~3.8 mm)和3.6 mm(标准差0.6；2.0~5.3；CI 2.4 mm~4.7 mm)。平均绝对差值为0.9 mm(标准差为0.5；-0.7~1.5；CI为-0.1 mm~1.8 mm)。94个踝关节中，92个踝关节(98%)上间隙大于或等于内侧间隙。结论：了解踝关节上、内侧间隙的正常X线关系有助于诊断踝关节韧带不稳定，并可避免额外的诊断试验。
Background: The width of the medial clear space often is used to determine the integrity of the deltoid ligament, the primary medial stabilizer of the ankle joint. The normal clinical relationship of the superior clear space to the medial clear space is not well described. This investigation sought to determine if the superior clear space constitutes an accurate point of comparison for the medial clear space and a means for assessing ligamentous stability in an adult ankle. Methods: A retrospective review of consecutive ankle radiographs for a 4-month period of time was completed using a university-based radiology database. Using a digitally calibrated ruler, the widths of the medial and superior clear spaces were measured on the mortise view. These values were compared using a Student's t-test. Results: Digital radiographs of 564 consecutive ankles were reviewed retrospectively and 94 cases were without evidence of trauma, surgery, or degenerative disease. The medial and superior clear spaces were measured on the mortise view and found to be 2.7 mm (standard deviation 0.5; range 1.3 mm to 4.3 mm; 95% confidence interval 1.7 mm to 3.8 mm) and 3.6 mm (standard deviation 0.6; 2.0 to 5.3; CI 2.4 mm to 4.7 mm), respectively. The average absolute difference was 0.9 mm (standard deviation 0.5; -0.7 to 1.5; CI -0.1 mm to 1.8 mm) and in 92 of 94 ankles (98%), the superior clear space was greater than or equal to the medial clear space. Conclusions: Understanding the normal radiographic relationship of the superior and medial clear spaces may help in the diagnosis of ligamentous instability in the ankle and may obviate the need for additional diagnostic tests.