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Skeletal Radiology

, Volume 45, Issue 3, pp 333–338 | Cite as

Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

  • Rahul KotwalEmail author
  • Narendra Rath
  • Vishal Paringe
  • Sandeep Hemmadi
  • Rhys Thomas
  • Kath Lyons
Scientific Article

Abstract

Objectives

To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients.

Materials and methods

Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery.

Results

After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %).

Conclusion

Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified.

Keywords

Ankle syndesmosis Computed tomography 

Notes

Source of funding

None

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© ISS 2015

Authors and Affiliations

  • Rahul Kotwal
    • 1
    Email author
  • Narendra Rath
    • 2
  • Vishal Paringe
    • 3
  • Sandeep Hemmadi
    • 3
  • Rhys Thomas
    • 3
  • Kath Lyons
    • 3
  1. 1.Princess of Wales HospitalBridgendUK
  2. 2.Royal Gwent HospitalNewportUK
  3. 3.University Hospital of WalesCardiffUK

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