O1282 THE EVALUATION OF THE SYNDESMOTIC DISRUPTION BY MRI-ARTHROGRAPHY AT DENIS WEBER TYPE B AND C ANKLE FRACTURES

Abstract

Aims: We aimed to evaluate diagnostic contribution of MRI-Arthrography in syndesmosis disruption at ankle fractures. Methods: 18 patient who had Denis Weber type B-C fractures and are suspected to have syndesmotic diastasis considering tibiofibular clear space and tibiofibular overlap measurments in conventional radiographs are assesed with MRI followed by MRI-Arthrography. Because joint fluid was already seen in tibiofibular space in 3 patients at MRI, MRI-Arthrography was performed for the remaining 15 patients. If there was a changes between the results obtained from MRI and the results obtained after MRI-arthrography was tested istatistically. Convantional radiographs, MRIs and MRI-Arthrographies were analysed by 2 independent observers and interobserver concordance was assesed. Following intraoperative observation and asssesment syndesmotic diastasis was treated considering radiographic and MRI-arthrographic results. Results: In 15 cases who were regarded to have syndesmotic diastasis according to conventional radiographies, 8 (53.3%) diastasis were confirmed with only MRI and 12 (80%) diastasis were confirmed with MRI arthrography. Following intraoperative assesment 13 (86.6%) cases were regarded to have diastasis and surgical intervention was performed for diastasis repair. In 2 (13.3%) cases surgical intervention for diastasis repair was not performed. If there was a change in decission after MRI and after MRI-arthrography is analysed with chi-square test between related groups. There were statistically significiant difference (p< 0.05) in these means. There is interobserver concordance in conventional radiographic, MRI-arthrographic assesments and in assesments for ATIF and PTIF seperately inMRI.(p< 0.001). Conclusion: These results suggest that conventional radiography and MRI is not sufficient in assesing syndesmosis and MRI-arthrography is important for diagnosis.