The assessment of the accuracy of reduction of the ankle syndesmosis has traditionally been made using plain radiographic measurements. Recent studies have shown that computerized tomography (CT) scan is more sensitive than radiographs in detecting diastasis. The ethos has now therefore shifted towards CT scan assessment of the syndesmosis. There is however no validated method to scan the syndesmosis and measure it on the CT scans. This exposes the patient to significant radiation risk and also to anxiety from inappropriate interpretation from these scans. The objectives of this research project are to investigate the current practice of CT scanning the syndesmosis at a University Hospital and to devise a new CT protocol to reduce radiation exposure to patients and to assist surgeons in interpreting the observations. Research Ethics Committee approval was obtained. Current practice was evaluated. A new 5 cut CT protocol was devised. Starting at the level of the distal tibial plafond, 5 cuts were made proximally 0.5 cm apart. Accuracy of the syndesmosis reduction was assessed just above the distal tibial plafond. Both the injured and the normal sides were scanned 12 weeks post surgery. The normal side served as a control.Introduction
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