Morphological characteristics of distal fibula and their clinical relevance: a research based on computer-assisted orthopaedic techniques

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) . 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, precontour of the plate before insertion is required. Key words: Fibula; Ankle joint; Fracture, bone; Imaging, three-dimensional; Tomography, X-ray computed