Anatomy of anterior talofibular ligament and calcaneofibular ligament for minimally invasive surgery: a systematic review

Matsui, Kentaro; Takao, Masato; Tochigi, Yuki; Ozeki, Satoru; Glazebrook, Mark

doi:10.1007/s00167-016-4194-y

Cited by 84 publications

(76 citation statements)

References 40 publications

(277 reference statements)

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“…Previous anatomic study of ATFL delineates the course of ATFL from fibula to talus. The fibular origin of ATFL was reported to be 10 to 13.8 mm proximal to the tip of the fibula [28], which is approximately the midpoint between the inferior tip and anterior tubercle of the fibula. The talar insertion of ATFL was reported to be 14.2 to 18.1 mm to the subtalar joint or 11.3 to 14.8 mm to the anterolateral corner of the talar body [28], which is approximately the midpoint between the lateral talar process and the anterolateral corner of the trochlea.…”

Section: Discussionmentioning

confidence: 99%

“…The fibular origin of ATFL was reported to be 10 to 13.8 mm proximal to the tip of the fibula [28], which is approximately the midpoint between the inferior tip and anterior tubercle of the fibula. The talar insertion of ATFL was reported to be 14.2 to 18.1 mm to the subtalar joint or 11.3 to 14.8 mm to the anterolateral corner of the talar body [28], which is approximately the midpoint between the lateral talar process and the anterolateral corner of the trochlea. ATFL was reported to be directed at approximately 45° medially from the sagittal plane and at approximately 25° inferiorly from the horizontal plane [11, 12].…”

Section: Discussionmentioning

confidence: 99%

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Reliability and validity of different ankle MRI scanning planes for the anterior talofibular ligament injury diagnosis: a cadaveric study

Cao

Wang

et al. 2019

J Orthop Surg Res

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Background The objective of the current study is to compare reliability, accuracy, sensitivity, and specificity in magnetic resonance imaging (MRI) evaluation of anterior talofibular ligament (ATFL) among the routine axial scanning plane, oblique axial-coronal scanning plane, and oblique axial-sagittal scanning plane. Methods Twenty cadaveric feet were studied. ATFL was exposed before scanning. Routine axial, oblique axial-coronal, and oblique axial-sagittal MRI scanning of 20 ATFL-intact cadaveric feet were acquired utilizing a 1.5-T MRI unit. The scans were repeated on the 20 cadaveric feet after the ATFL was artificially injured. In total, 120 sets of MR images were obtained and were randomly numbered. Three independent observers who were blinded to the experiment evaluated the images. Interobserver agreement, sensitivity, specificity, and accuracy were calculated and compared between different scanning planes utilizing the McNemar test. Results The interobserver agreement was fair to good (kappa, 0.55 to 0.65) in the routine axial plane, fair to good (kappa, 0.557 to 0.75) in the oblique axial-sagittal plane, and excellent (kappa, 0.85 to 0.95) in the oblique axial-coronal plane. The accuracy was significantly higher when utilizing oblique axial-coronal MRI scanning than routine axial MRI scanning (reader 1: p = .018; reader 2: p = .005). Conclusions The diagnostic accuracy of oblique axial-coronal plane MRI was higher than the routine axial plane concerning ATFL injury, and the interobserver agreement was excellent. The oblique axial-coronal plane could be added to the MRI scanning protocol during clinical practices to improve the diagnostic accuracy of ATFL injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reliability and validity of different ankle MRI scanning planes for the anterior talofibular ligament injury diagnosis: a cadaveric study

Cao

Wang

et al. 2019

J Orthop Surg Res

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“…These variables limit the use of percutaneous technique. Secondly, the risk of injury sural nerve is relatively high when using percutaneous technique [15, 29]. Therefore, careful “nick and spread" technique should be used to avoid injury the nerve.…”

Section: Discussionmentioning

confidence: 99%

No Difference between Percutaneous and Arthroscopic Techniques in Identifying the Calcaneal Insertion during Ankle Lateral Ligament Reconstruction: A Cadaveric Study

Liu

Zhou

et al. 2019

BioMed Research International

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Background. Both percutaneous and arthroscopic techniques have been introduced in anatomic ankle lateral ligaments reconstruction. The purpose of this study was to compare these two techniques in identifying the calcaneal insertion of the calcaneofibular ligament (CFL). Methods. Fifteen fresh-frozen human ankle cadaver specimens were used in this study. Each specimen was tested in three stages. For stage 1, each specimen was evaluated under arthroscopy. After debridement was performed, the insertion of the CFL on the calcaneus was identified, and a 1.5mm Kirschner wire was drilled at the center of the insertion. For stage 2, a percutaneous technique was used to identify the center of the insertion of the CFL. A second 1.5 mm Kirschner wire was drilled through the skin marker. For stage 3, the ankle was dissected, the footprint of the CFL was identified under direct vision, and the distances between the center of the CFL insertion on the calcaneus and the two Kirschner wires were measured, respectively. Results. In the arthroscopic technique group, the mean distance from the Kirschner wire to the center of the CFL insertion in the calcaneus was 3.4 ± 1.3 mm. In the percutaneous technique group, the mean distance from the Kirschner wire to the center of the CFL insertion was 3.2 ± 1.4 mm. No significant difference was found between the two groups. Conclusion. No difference in identifying the calcaneal insertion of the CFL was found between the percutaneous and the arthroscopic ankle lateral ligaments reconstruction technique. Both techniques can be used during anatomic ligaments reconstruction in treatment of chronic ankle instability.

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“…To date, however, no technical reports have focused on the safe creation method of the fibular tunnel during arthroscopic ATFL and CFL reconstruction. Because of the connection between the ATFL and CFL, 20 , 21 1 fibular tunnel is more reasonable and safer than the creation of 2 fibular tunnels. 4 When the anatomical fibular tunnel is drilled through the AAL portal, the drill will pass anteroinferiorly to posterosuperiorly; therefore, the risk of the intraoperative fracture of the tunnel wall is greater.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Arthroscopic Anterior Talofibular Ligament and Calcaneofibular Ligament Reconstruction Using an Autogenic Hamstring Tendon: Safe Creation of Anatomical Fibular Tunnel

Higashiyama

Aikawa

Iwase

et al. 2019

Arthroscopy Techniques

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Ankle sprains are the most common lower extremity injuries associated with sports activity. Although ligament repair techniques are popular, reconstruction methods using free tendons are considered when the ligament remnant is insufficiently strong, when high-demand athletes sustain repeat ankle sprains, or in revision cases after repair. Recently, some arthroscopic reconstruction techniques have been reported. The distal fibular end is thin; therefore, surgeons must be careful while drilling the fibular tunnel. This report indicates the safe creation method of an anatomical fibular tunnel during anatomical arthroscopic reconstruction of the anterior talofibular ligament and calcaneofibular ligament. This also provides a stronger reconstruction using a 2-strand tendon graft for the anterior talofibular ligament substitute, which is thought to have less risk for postoperative graft failure.

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Anatomy of anterior talofibular ligament and calcaneofibular ligament for minimally invasive surgery: a systematic review

Abstract: Systematic review, Level IV.

Cited by 84 publications

References 40 publications

Reliability and validity of different ankle MRI scanning planes for the anterior talofibular ligament injury diagnosis: a cadaveric study

Reliability and validity of different ankle MRI scanning planes for the anterior talofibular ligament injury diagnosis: a cadaveric study

No Difference between Percutaneous and Arthroscopic Techniques in Identifying the Calcaneal Insertion during Ankle Lateral Ligament Reconstruction: A Cadaveric Study

Anatomical Arthroscopic Anterior Talofibular Ligament and Calcaneofibular Ligament Reconstruction Using an Autogenic Hamstring Tendon: Safe Creation of Anatomical Fibular Tunnel

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