Tibiofibular clear space
The tibiofibular clear space (TFCS) is a radiographic measure and defined as the space between the groove of the distal tibial prominence and the medial margin of the distal fibula .
Usage
Together with the tibiofibular overlap (TFO) and the medial clear space the tibiofibular clear space has been used in the diagnosis of syndesmotic injury and the assessment of its repair .
Measurement
The horizontal distance between the deepest point of the fibular groove or posterior tibial tubercle and the medial edge of the distal fibula 1 cm above the tibial plafond are measured in a normal anteroposterior view of the ankle .
Interpretation
In the context of an absence of any tibiofibular overlap (TFO <0) and a widened medial clear space a horizontal distance of > 6mm has been considered abnormal .
Practical points
There is some debate on how useful this measurement with the above parameters for the prediction of a syndesmotic injury really is . Apparently correlation of the tibiofibular clear space (TFCS) and tibiofibular overlap (TFO) with the finding of syndesmotic injury in MRI is quite poor . Although it seems to have some value in the assessment of the reduction .
See also
