Anatomic Variations and MRI of the Intermalleolar Ligament

Oh, Chang Seok; Won, Hyung‐Sun; Hur, Mi Sun; Chung, In Hyuk; Kim, Sungjun; Suh, Jin Suck; Sung, Ki-Sun

doi:10.2214/ajr.04.1784

Cited by 63 publications

(44 citation statements)

References 13 publications

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“…Golanó et al [ 38 ] identifi ed this ligament in all his dissections as well as in the arthroscopic study performed. In our opinion, the difference in frequency is probably due to the small size of the posterior intermalleolar ligament (mean 2.3 mm, range 1-5 mm), interracial variations [ 68 ], and the fact that it is diffi cult to dissect [ 38 ]. In addition, the ligament may be divided (20 % [ 66 ]-100 % [ 68 ]) into 2 or 3 different bands, any of which may not achieve bony insertion and become inserted in the joint capsule of the ankle.…”

Section: Posterior Talofi Bular Ligamentmentioning

confidence: 71%

“…The author ascribed the difference to the possibility that among these patients the ligament would be more obvious on MRI because of scar thickening and infl ammation resulting from repeated trauma. In the recent study of Oh et al [ 68 ] on the morphology of the posterior intermalleolar ligament and its correlation with MR images, the posterior intermalleolar ligament was observed in 81.8 % of the specimens.…”

Section: Posterior Talofi Bular Ligamentmentioning

confidence: 92%

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Anatomy of the Ankle

Golanó

Dalmau-Pastor

Vega³

et al. 2014

Sports and Traumatology

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A thorough knowledge of the ankle anatomy is absolutely necessary for diagnosis and adequate treatment of ankle injury. The ankle is among the most prevalent joints injured in sports, the ankle sprain being the most common ankle lesion. The ankle joint is formed by the distal tibia and fi bula, and the superior talus. Two ligamentous complexes join the bones that form the ankle: the ligaments of the tibiofi bular syndesmosis (anteroinferior tibiofi bular, posteroinferior tibiofi bular, and the interosseous tibiofi bular ligament) and the lateral (anterior talofi bular, calcaneofi bular, and the posterior talofi bular ligament) and medial (superfi cial and deep

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Section: Posterior Talofi Bular Ligamentmentioning

confidence: 71%

Section: Posterior Talofi Bular Ligamentmentioning

confidence: 92%

Anatomy of the Ankle

Golanó

Dalmau-Pastor

Vega³

et al. 2014

Sports and Traumatology

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“…14). According to Oh et al. (2006) the intermalleolar ligament is a separate anatomic entity and was almost invariably present in 81.8% of 77 specimens (Golano et al.…”

Section: The Syndesmotic Ligamentsmentioning

confidence: 99%

Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach

et al. 2010

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A syndesmosis is defined as a fibrous joint in which two adjacent bones are linked by a strong membrane or ligaments. This definition also applies for the distal tibiofibular syndesmosis, which is a syndesmotic joint formed by two bones and four ligaments. The distal tibia and fibula form the osseous part of the syndesmosis and are linked by the distal anterior tibiofibular ligament, the distal posterior tibiofibular ligament, the transverse ligament and the interosseous ligament. Although the syndesmosis is a joint, in the literature the term syndesmotic injury is used to describe injury of the syndesmotic ligaments. In an estimated 1-11% of all ankle sprains, injury of the distal tibiofibular syndesmosis occurs. Forty percent of patients still have complaints of ankle instability 6 months after an ankle sprain. This could be due to widening of the ankle mortise as a result of increased length of the syndesmotic ligaments after acute ankle sprain. As widening of the ankle mortise by 1 mm decreases the contact area of the tibiotalar joint by 42%, this could lead to instability and hence early osteoarthritis of the tibiotalar joint. In fractures of the ankle, syndesmotic injury occurs in about 50% of type Weber B and in all of type Weber C fractures. However, in discussing syndesmotic injury, it seems the exact proximal and distal boundaries of the distal tibiofibular syndesmosis are not well defined. There is no clear statement in the Ashhurst and Bromer etiological, the LaugeHansen genetic or the Danis-Weber topographical fracture classification about the exact extent of the syndesmosis. This joint is also not clearly defined in anatomical textbooks, such as Lanz and Wachsmuth. Kelikian and Kelikian postulate that the distal tibiofibular joint begins at the level of origin of the tibiofibular ligaments from the tibia and ends where these ligaments insert into the fibular malleolus. As the syndesmosis of the ankle plays an important role in the stability of the talocrural joint, understanding of the exact anatomy of both the osseous and ligamentous structures is essential in interpreting plain radiographs, CT and MR images, in ankle arthroscopy and in therapeutic management. With this pictorial essay we try to fill the hiatus in anatomic knowledge and provide a detailed anatomic description of the syndesmotic bones with the incisura fibularis, the syndesmotic recess, synovial fold and tibiofibular contact zone and the four syndesmotic ligaments. Each section describes a separate syndesmotic structure, followed by its clinical relevance and discussion of remaining questions.

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“…1 and 4). Previously, MRIs of cadaver ankles were examined to study the ligament morphology (Oh et al, 2006). But the MRIs are not enough to recognize full courses of tiny ligaments.…”

Section: Discussionmentioning

confidence: 99%

Portable Document Format File Containing the Surface Models to Learn the Stereoscopic Shape of Foot Muscles

2015

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SUMMARY:We intended to present a portable document format (PDF) file containing stereoscopic surface models of the foot. While other surface models are subjectively drawn based on anatomical knowledge, our models are reconstructed from high quality sectioned images. Unlike other models, ours in the complimentary PDF file can also be saved on individual user computers to be manipulated off-line. The skin, 27 bones, 24 muscles, and 19 ligaments in the foot were delineated on a male cadaver's sectioned images from the Visible Korean project. After stacking the outlines of the structures, other than those of the ligaments, surface reconstruction was performed. The resultant surface models were placed in a PDF file, in which the models could be superimposed on either the corresponding sectioned images or the color-filled outline images. PDF bookmarks were established to exhibit the groups of foot muscles conveniently. The PDF file prepared in this research is likely to be very useful for comprehension of the topographic anatomy of the foot muscles. The models it contains can be extracted by other researchers for their own virtual dissection or surgery visualization of foot as desired.

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Anatomic Variations and MRI of the Intermalleolar Ligament

Abstract: The intermalleolar ligament seemed to be an almost invariably present anatomic entity with diverse morphologic features on MR images.

Cited by 63 publications

References 13 publications

Anatomy of the Ankle

Anatomy of the Ankle

Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach

Portable Document Format File Containing the Surface Models to Learn the Stereoscopic Shape of Foot Muscles

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