Table 1 The classification system of tibiofibular syndesmosis blood supply based on the presence of the lateral anterior malleolar artery.
From: Classification system of the tibiofibular syndesmosis blood supply and its clinical relevance
Type I (72%) Anterior aspect of syndesmosis supplied by lateral anterior malleolar artery from anterior tibial artery and by anterior branch of fibular artery | Type IA – lateral anterior malleolar artery present and supplies anterior aspect of syndesmosis indirectly connecting to the anterior branch of fibular artery (52%) (Fig. 1) Vascular density – 4.5% |
Type IB – lateral anterior malleolar artery present and supplies anterior aspect of syndesmosis directly (16%) (Figs 2 and 3) Vascular density – 5.8% | |
Type IC – Type IA or IB with coexisting anatomical variation of blood supply to posterior aspect of tibiofibular syndesmosis (4%) (Fig. 4) Vascular density – 4.2% | |
Type II (28%) Anterior aspect of tibiofibular syndesmosis supplied exclusively by anterior branch of fibular artery, with lack of lateral anterior malleolar artery | Type IIA – lack of lateral anterior malleolar artery but presence of anterior tibial artery (24%) (Fig. 5) Vascular density – 3.8% |
Type IIB – lack of anterior tibial and lateral malleolar artery (4%) (Fig. 6) Vascular density – 3.5% | |
Type IIC – Type IIA or IIB with coexisting anatomical variation of blood supply to posterior aspect of tibiofibular syndesmosis (not obtained in our study – 0%) Vascular density – N/A |
