An Attachment-Based Description of the Medial Collateral and Spring Ligament Complexes

Cromeens, Barrett P.; Kirchhoff, Claire A; Patterson, Rita M.; Motley, Travis A.; Stewart, Donald H.; Fisher, Cara; Reeves, Rustin

doi:10.1177/1071100715572221

Cited by 64 publications

(56 citation statements)

References 31 publications

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“…Campbell et al demonstrated that the deep posterior tibiotalar, tibionavicular and tibiospring ligament were most consistently found in the deltoid ligament complex and that fibers from the superficial deltoid ligament coalesce with the dorsal aspect of the spring ligament (Campbell et al, 2014a). Furthermore, the tibiospring and tibionavicular ligaments, also known as the tibiocalcaneonavicular ligament (TCNL), have the largest total attachment area in the medial aspect of the medial ligament complex (Cromeens et al, 2015). Therefore, one would surmise that the TCNL provides significant medial stability to the ankle joint.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, advanced AAFD is often accompanied by a spring ligament insufficiency (Deland et al, 2005) that can lead to worsening medial instability and deltoid dysfunction despite surgical management (Deland, 2008). Recent anatomic studies suggest that spring and deltoid ligaments are not separate entities, but rather that they form a large confluent ligament, the tibiocalcaneonavicular ligament (TCNL) (Campbell et al, 2014a;Cromeens et al, 2015). Previous studies reported progressive radiographic and clinical loss of correction achieved with surgical reconstruction of Stage II AAFD (Bolt et al, 2007;Niki et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Spring ligament tear decreases static stability of the ankle joint

Kelly

Masqoodi

Vasconcellos

et al. 2019

Clinical Biomechanics

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spring ligament tear decreases static stability of the ankle joint

Kelly

Masqoodi

Vasconcellos

et al. 2019

Clinical Biomechanics

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“…Two ligamentous bands comprise the deep layer of the deltoid ligament: the deep anterior and posterior tibiotalar ligaments. Generally, the deltoid ligament is known to work cooperatively and is primarily responsible for 1) stabilizing the medial side of the ankle to limit anterior, posterior, and lateral translation of the talus and 2) restraining talar abduction at the talocrural joint [2,6]. Specifically, the superficial deltoid resists eversion of the hindfoot, and the deep deltoid is the primary restraint to external rotation of the talus [5,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Strain pattern of each ligamentous band of the superficial deltoid ligament: a cadaver study

Takao¹,

Ozeki

Oliva

et al. 2020

Preprint

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BackgroundThere are few reports on the detailed biomechanics of the deltoid ligament, and no studies have measured the biomechanics of each ligamentous band because of the difficulty in inserting sensors into the narrow ligaments. This study aimed to measure the strain pattern of the deltoid ligament bands directly using a Miniaturization Ligament Performance Probe (MLPP) system. MethodsThe MLPP was sutured into the ligamentous bands of the deltoid ligament in 6 fresh-frozen lower extremity cadaveric specimens. The strain was measured using a round metal disk (clock) fixed on the plantar aspect of the foot. The ankle was manually moved from 15° dorsiflexion to 30° plantar flexion, and a 1.2-N-m force was applied to the ankle and subtalar joint complex. Then the clock was rotated every 30° to measure the strain of each ligamentous band at each endpoint. ResultsThe tibionavicular ligament (TNL) began to tense at 10° plantar flexion, and the tension becomes stronger as the angle increased; the TNL worked most effectively in plantar flex-abduction. The tibiospring ligament (TSL) began to tense gradually at 15° plantar flexion, and the tension became stronger as the angle increased. The TSL worked most effectively in abduction. The tibiocalcaneal ligament (TCL) began to tense gradually at 0° dorsiflexion, and the tension became stronger as the angle increased. The TCL worked most effectively in pronation (dorsiflexion-abduction). The superficial posterior tibiotalar ligament (SPTTL) began to tense gradually at 0° dorsiflexion, and the tension became stronger as the angle increased, with the SPTTL working most effectively in dorsiflexion. ConclusionOur results show the biomechanical function of the superficial deltoid ligament and may contribute to determining which ligament is damaged during assessment in the clinical setting. Ethics approval and consent to participateThis cadaveric study was approved by the Institutional Review Board of the University of Barcelona and conducted in accordance with the bylaws of the Bioethics Committee of the "Unitat d' Anatomia i Embriologia humana"

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“…Two ligamentous bands make up the deep layer of the deltoid ligament: the deep anterior and posterior tibiotalar ligaments. Generally, the deltoid ligament is known to work cooperatively and is primarily responsible for 1) stabilizing the medial side of the ankle to limit anterior, posterior, and lateral translation of the talus and 2) restraining talar abduction at the talocrural joint [2,6]. Specifically, the superficial deltoid resists eversion of the hindfoot and the deep deltoid is the primary restraint to external rotation of the talus [5,7,8,9].…”

Section: Introductionmentioning

confidence: 99%