Independent Attachment of Lateral Ankle Ligaments: Anterior Talofibular and Calcaneofibular Ligaments - A Cadaveric Study

Kakegawa, Akira; Mori, Yusuke; Tsuchiya, Atsushi; Sumitomo, Norimi; Fukushima, Nanae; Moriizumi, Tetsuji

doi:10.1053/j.jfas.2018.12.009

Cited by 40 publications

(48 citation statements)

References 29 publications

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“…This is because the distance between the bony landmark of the fibula and fibular footprint of the ATFL and CFL can be measured differently depending on the size and race of the cadaver. In previous cadaveric studies using 60 and 152 cadavers [23,25], the ATFL and CFL were found to connect to each other at the anterior border of the lateral malleolus. The results of this study also showed connective fibers between ATFL and CFL covering the surface layer of the inferior part of ATFL and the anterior part of CFL in all 105 specimens.…”

Section: Discussionmentioning

confidence: 83%

“…Previous studies reported anatomical variations of the ATFL with regard to the number of bundles [18,22,23,25]. Thus, there is a possibility that the location of the fibular tunnel may differ depending on the type of the bundle pattern of the ATFL.…”

Section: Discussionmentioning

confidence: 99%

“…The previous cadaveric study by Matsui et al [8] suggested the fibular obscure tubercle (FOT) as a bony landmark for identifying the fibular footprint of the lateral ankle ligament. Some authors described the articular and inferior tips of the fibula (lateral malleolus) as a reference point [22][23][24]. However, it is somewhat insufficient to determine the location of the fibular tunnel as a common origin site of the ATFL and CFL with only one or two reference points in MIS procedures for CAI.…”

Section: Discussionmentioning

confidence: 99%

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The Location of the Fibular Tunnel for Anatomically Accurate Reconstruction of the Lateral Ankle Ligament: A Cadaveric Study

Park

Kwon

Kim

et al. 2021

BioMed Research International

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We aimed to describe the location of fibular footprint of each anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL), as well as their common origin in relation to bony landmarks of the fibula in order to determine the location of the fibular tunnel. In 105 ankle specimens, the center of the footprints of the ATFL and CFL (cATFL and cCFL, respectively) and the intersection point of their origin (intATFL-CFL) were investigated, and the distances from selected bony landmarks (the articular tip (AT) and the inferior tip (IT) of the fibula) were measured. Forty-two (40%) specimens had single-bundle ATFL, and 63 (60%) had double-bundle patterns. The distance between intATFL-CFL and IT was 12.0 ± 2.5 mm , and a significant difference was observed between the two groups ( p = 0.001 ). Moreover, the ratio of the intATFL-CFL location based on the anterior fibular border for all cadavers was 0.386. The present study suggests a reference ratio that can help surgeons locate the fibular tunnel for a more anatomically accurate reconstruction of the lateral ankle ligament. Also, it may be necessary to make a difference in the location of the fibular tunnel according to the number of ATFL bundles during surgery.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Location of the Fibular Tunnel for Anatomically Accurate Reconstruction of the Lateral Ankle Ligament: A Cadaveric Study

Park

Kwon

Kim

et al. 2021

BioMed Research International

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“…This reduction can develop of the overuse changes, the paratendinitis or the tendinopathy of the Achilles tendon. The presence of connections to ligaments such as the PTFL or CFL helps to understand why isolated tears are rare in the ankle area [9,17]. Given the existence of the connections within the KFP, it is somewhat more logical to understand the coexistence of the overuse of the Achilles tendon with alterations in other structures in the ankle.…”

Section: Discussionmentioning

confidence: 99%

The Kager’s fat pad radiological anatomy revised

Szaro

Polaczek²,

Ciszek

2020

Surg Radiol Anat

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Purpose The aim of the study was to map connections within the Kager’s fat pad between the structures which limit it. Methods A retrospective re-review of 200 ankle magnetic resonance imaging (MRI) examination was conducted. Connections within the Kager’s fat pad between the superior peroneal retinaculum, the fibulotalocalcaneal ligament, the posterior talocalcaneal ligament, the flexor hallucis longus, the paratenon of the Achilles tendon, the flexor retinaculum and bones were studied and a model of the connections was constructed. Results The superior peroneal retinaculum was directly connected with the fibulotalocalcaneal ligament in 85.5% of cases, the lateral part of the paratenon in 82.5%, the processus posterior tali in 78.5%, the posterior talofibular ligament in 32%, the flexor retinaculum in 29.5% and the anterior talofibular ligament in 9%. The fibulotalocalcaneal ligament was connected with the paratenon (on the medial side 88.5%, on the lateral side 68.5%), the flexor retinaculum in 70%, the posterior process of the talus in 79%, the osteofibrosus tunnel for the flexor hallucis longus in 53%, the posterior talofibular ligament in 43.5% and the calcaneofibular ligament in 10.5%. The posterior talocalcaneal ligament was connected with the fibulotalocalcaneal ligament in 71%, with the osteofibrosus tunnel for the flexor hallucis longus in 76.5%, with the flexor retinaculum in 70%. The plantaris tendon showed projection to the crural fascia in 34 of % cases. Conclusion In the Kager’s fat pad there are present more connections than previously reported. All the connections unit at the level of the posterior process of the talus.

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“…In comparison with other cadaver studies which have defined ATFL, the mean age of the cadavers, the mean BMI measurements have been reported to be similar to our study but this cadaveric specimens mostly embalmed specimens. 26,27 In our study, we used fresh-frozen, nonpaired specimens that is proper evaluation of tendons and ligament of anthropometry. 25 The diameters of the hamstring tendons were measured while applying 89 newtons of force for reduce graft creep in our study that is similar to literature.…”

Section: Discussionmentioning

confidence: 99%

Hamstring autograft and anatomical footprint evaluation for anterior talofibular ligament reconstruction: Cadaveric study

Karahan

Kaya

Yılmaz

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: The aim of the study was to evaluate whether or not there was any incompatibility between two-strand hamstring tendons taken from the same knee and the ATFL and it was the determination of suitable footprint points in the fibula and talus for anatomical ATFL reconstruction. Methods: 16 fresh frozen cadaver specimens were dissected to gracilis and semitendinosus tendons and the anterior talofibular ligament. The origins, insertions, distances from osseous landmarks of fibular talus of ATFL were determined. The diameters of gracilis, semitendinosus and ATFL were calculated. There was a moderate correlation between body height and the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL (r: 36.5 p: 0.036). There was a weak correlation between body height and the distance between the apex of the lateral talar process and the talus adhesion site of ATFL in a single bundle (r: 28.4 p: 0.002). There was no correlation between the distance from proximal and distal adhesion side of ATFL and body height in the double bundle (p: 0.241). Results: There was no significant relationship between ATFL diameter and gracilis, semitendinosus and both hamstring in women. A significant relationship at 80.5% was determined between the ATFL and the gracilis diameter in man. A significant relationship at 92.6% was determined between the ATFL and the semitendinosus diameter in man. Conclusion: It was determined that there is not compatibility between the gracilis tendons, the semitendinosus tendon and ATFL in women. It should be supported by biomechanical and clinical studies whether this incompatibility has a clinical effect or not.

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Independent Attachment of Lateral Ankle Ligaments: Anterior Talofibular and Calcaneofibular Ligaments - A Cadaveric Study

Cited by 40 publications

References 29 publications

The Location of the Fibular Tunnel for Anatomically Accurate Reconstruction of the Lateral Ankle Ligament: A Cadaveric Study

The Location of the Fibular Tunnel for Anatomically Accurate Reconstruction of the Lateral Ankle Ligament: A Cadaveric Study

The Kager’s fat pad radiological anatomy revised

Hamstring autograft and anatomical footprint evaluation for anterior talofibular ligament reconstruction: Cadaveric study

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