Morphological characteristics of distal fibula and their clinical relevance: a research based on computer-assisted orthopaedic techniques / 中华创伤骨科杂志

ABSTRACT

Objective To provide references for anatomical reduction and correct implantation in treatment of distal fibular fracture by analyzing morphological characteristics of distal fibula on three-dimensional (3D) modes.Methods 16-row spiral CT scans of 126 normal ankle structures from May 2009 to June 2014 were collected.Surface shaded display technique was used to reconstruct 3-D images of bones around the ankle.The distal fibula was extracted using 3D segmentation technique.The parameters of distal fibula were measured by selecting points,lines and surfaces on the 3D models.Results The morphological characteristics of distal fibula were complicated.Significant differences were observed between males and females in most parameters (P ＜ 0.05),but not in the length between the plane of the most lateral point of the tibial anterior node and the most distal point of the fibula,the length between the midpoint of lateral border of the fibula and its opposite cortex on the plane of the most proximal border of the fibular fossa or the mean angle of posterior crest of the fibula (P ＞ 0.05).The intra and interclass correlation coefficients (ICC) were excellent.Conclusions When a lateral plate is used for internal fixation of distal fibula,the plate should be placed as proximally as possible.When a posterior-lateral plate is used,the screws to be inserted on the plane proximal to the initial point of anterior node of the tibia can be fixed bi-cortically.When a posterior plate is used,pre-contour of the plate before insertion is required.