Anatomical variations and interconnections of the superior peroneal retinaculum to adjacent lateral ankle structures: a preliminary imaging anatomy study

Drakonaki, Eleni E.; Gataa, Khaldun Ghali; Solidakis, Nektarios; Szaro, Paweł

doi:10.15557/jou.2021.0003

Cited by 9 publications

(5 citation statements)

References 33 publications

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“…First, the patients in the CN group were not completely healthy and had some foot and ankle conditions. Lateral ankle conditions may be related to peroneal tendon pathology, and previous studies 2,4 have reported a relationship between injuries to the superior peroneal retinaculum and lateral ankle ligament injuries. Thus, patients with lateral ankle conditions, including chronic lateral ankle instability, were excluded from this study.…”

Section: Discussionmentioning

confidence: 89%

Anatomic Features of Patients With Recurrent Peroneal Tendon Dislocation

et al. 2023

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Background: There are several anatomic variations of the peroneal muscles and lateral malleolus of the ankle that may play an important role in the onset of peroneal tendon dislocation. Purpose: To investigate the anatomic variations of the retromalleolar groove and peroneal muscles in patients with and without recurrent peroneal tendon dislocation using magnetic resonance imaging (MRI) and computed tomography (CT). Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 30 patients (30 ankles) with recurrent peroneal tendon dislocation who underwent both MRI and CT before surgery (PD group) and 30 age- and sex-matched patients (control [CN] group) who underwent MRI and CT were included in this study. The imaging was reviewed at the level of the tibial plafond (TP level) and at the center slice between the TP and the fibular tip (CS level). The appearance of a malleolar groove (convex, concave, or flat) and the posterior tilting angle of the fibula were assessed on CT images. The appearance of accessory peroneal muscles, height of the peroneus brevis muscle belly, and volume of the peroneal muscle and tendons were assessed on MRI scans. Results: There were no differences in the appearance of the malleolar groove, posterior tilting angle of the fibula, or accessory peroneal muscles at the TP and CS levels between the PD and CN groups. The peroneal muscle ratio was significantly higher in the PD group than in the CN group at the TP and CS levels (both P < .001). The height of the peroneus brevis muscle belly was significantly lower in the PD group than in the CN group ( P = .001). Conclusion: A low-lying muscle belly of the peroneus brevis and a larger muscle volume in the retromalleolar space were significantly associated with peroneal tendon dislocation. Retromalleolar bony morphology was not associated with peroneal tendon dislocation.

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Section: Discussionmentioning

confidence: 89%

Anatomic Features of Patients With Recurrent Peroneal Tendon Dislocation

et al. 2023

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“…It is difficult to explain the origin and significance of asymmetry between MPO and IPL. However, we believe that there is a tendency to have smaller anatomical units in the ankle ligaments, which has been studied before [ 6 , 19 ]. In our group, the presence of additional fascicles or bifurcated bundles was observed more often in the group with two ligaments (group A) than in the group with three ligaments (group B).…”

Section: Discussionmentioning

confidence: 99%

Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study

2021

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Purpose The spring ligament complex (SL) is the chief static stabilizer of the medial longitudinal foot arch. The occurrence of normal anatomical variants may influence radiological diagnostics and surgical treatment. The aim of this study was to evaluate anatomical variants of the part of SL located inferior to the talar head (i-SL), medioplantar oblique ligament (MPO) and inferoplantar longitudinal ligament (IPL). Methods We included 220 MRI examinations of the ankle performed on a 3.0 T engine. Only patients with a normal SL were included. Two musculoskeletal radiologists assessed the examinations and Cohen’s kappa was used to assess agreement. Differences between groups were assessed using the chi-squared test; p < 0.05 was considered as significant. The final decision was made by consensus. Results Most commonly, i-SL was composed of the two ligaments IPL and MPO n = 167 (75.9%); in this group, bifid ligaments occurred in 19.2%, most commonly in the MPO. A branch to the os cuboideum was seen in n = 17 (10.2%). Three ligaments were seen in n = 52 (23.6%). In this group, bifid ligaments occurred in 13.5%; most commonly, the IPL was bifid and a branch to the os cuboideum was noted in n = 6 (11.5%). In one case, n = 1 (0.04%), we identified MPO, IPL and two accessory ligaments. No significant relationship was noted between the number of ligaments, the presence of bifid ligaments and side or gender (p > 0.05). Conclusion. More than two aligaments were seen in 24.1% of examined cases, the most common variant was the presence of MPO, IPL and one accessory ligament.

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“…Similarly, other interconnections between the Ultrasound shear wave elastography of the anterior talofibular and calcaneofibular ligaments in healthy subjects ligaments and surrounding structures would affect the SW measurements obtained. For example, the superior peroneal retinaculum can have connections to the ATFL in multiple varying locations (37) . Additionally, the peroneal tendons and sheaths superficially cross the CFL, leaving a concavity over the ligament in this region, which would also influence SW measurements, as the transducer may not be completely parallel to the ligament in this region.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound shear wave elastography of the anterior talofibular and calcaneofibular ligaments in healthy subjects

et al. 2021

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Aim of study: Most sprained lateral ankle ligaments heal uneventfully, but in some cases the ligament’s elastic function is not restored, leading to chronic ankle instability. Ultrasound shear wave elastography can be used to quantify the elasticity of musculoskeletal soft tissues; it may serve as a test of ankle ligament function during healing to potentially help differentiate normal from ineffective healing. The purpose of this study was to determine baseline shear wave velocity values for the lateral ankle ligaments in healthy male subjects, and to assess inter-observer reliability. Material and methods: Forty-six ankles in 23 healthy male subjects aged 20–40 years underwent shear wave elastography of the lateral ankle ligaments performed by two musculoskeletal radiologists. Each ligament was evaluated three times with the ankle relaxed by both examiners, and under stress by a single examiner. Mean shear wave velocity values were compared for each ligament by each examiner. Inter-observer agreement was evaluated. Results: The mean shear wave velocity at rest for the anterior talofibular ligament was 2.09 ± 0.3 (range 1.41–3.17); and for the calcaneofibular ligament 1.99 ± 0.36 (range 1.29–2.88). Good inter-observer agreement was found for the anterior talofibular ligament and calcaneofibular ligament shear wave velocity measurements with the ankle in resting position. There was a significant difference in mean shear wave velocities between rest and stressed conditions for both anterior talofibular ligament (2.09 m/s vs 3.21 m/s; p <0.001) and calcaneofibular ligament (1.99 m/s vs 3.42 m/s; p <0.0001). Conclusion: Shear wave elastography shows promise as a reproducible method to quantify ankle ligament stiffness. This study reveals that shear waves velocities of the normal lateral ankle ligaments increased with applied stress compared to the resting state.

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Anatomical variations and interconnections of the superior peroneal retinaculum to adjacent lateral ankle structures: a preliminary imaging anatomy study

Cited by 9 publications

References 33 publications

Anatomic Features of Patients With Recurrent Peroneal Tendon Dislocation

Anatomic Features of Patients With Recurrent Peroneal Tendon Dislocation

Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study

Ultrasound shear wave elastography of the anterior talofibular and calcaneofibular ligaments in healthy subjects

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