Morphological features of the anterior talofibular ligament by the number of fiber bundles

Edama, Mutsuaki; Kageyama, Ikuo; Kikumoto, Takanori; Nakamura, Masatoshi; Ito, Wataru; Nakamura, Emi; Hirabayashi, Ryo; Takabayashi, Tomoya; Inai, Takuma; Onishi, Hideaki

doi:10.1016/j.aanat.2017.11.001

Cited by 43 publications

(41 citation statements)

References 17 publications

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“…The fascicular feature of the ATFL was shown in anatomical studies 1,11 and one anatomical-radiological study by Delfaut et al 32 . Despite the amount of research, significant discrepancies in the frequency of the double fascicular ATFL from 25% 18 to 100% 9 are noticed.…”

Section: Discussionmentioning

confidence: 88%

“…The ATFL is the weakest part of the lateral ankle ligaments, which is usually the first and most common injured ligament in ankle inversions. The anterior talofibular ligament (ATFL) is composed of the superior (S-ATFL) and inferior fascicle (I-ATFL) [1][2][3][4][5][6][7] . Meanwhile, the calcaneofibular ligament (CFL) is composed of the medial (M-CFL) and lateral (L-CFL) 6,8,9 .…”

Section: Iermentioning

confidence: 99%

“…Meanwhile, the calcaneofibular ligament (CFL) is composed of the medial (M-CFL) and lateral (L-CFL) 6,8,9 . The interconnections between the ATFL, CFL, and the posteriori talofibular ligament (PTFL) provide integration between components making a complex of ligaments to a functional unit 1,10 .…”

Section: Iermentioning

confidence: 99%

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The double fascicular variations of the anterior talofibular ligament and the calcaneofibular ligament correlate with interconnections between lateral ankle structures revealed on magnetic resonance imaging

Szaro

Gataa

Polaczek

et al. 2020

Sci Rep

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The anterior talofibular ligament and the calcaneofibular ligament are the most commonly injured ankle ligaments. This study aimed to investigate if the double fascicular anterior talofibular ligament and the calcaneofibular ligament are associated with the presence of interconnections between those two ligaments and connections with non-ligamentous structures. A retrospective re-evaluation of 198 magnetic resonance imaging examinations of the ankle joint was conducted. The correlation between the double fascicular anterior talofibular ligament and calcaneofibular ligament and connections with the superior peroneal retinaculum, the peroneal tendon sheath, the tibiofibular ligaments, and the inferior extensor retinaculum was studied. The relationships between the anterior talofibular ligament’s and the calcaneofibular ligament’s diameters with the presence of connections were investigated. Most of the connections were visible in a group of double fascicular ligaments. Most often, one was between the anterior talofibular ligament and calcaneofibular ligament (74.7%). Statistically significant differences between groups of single and double fascicular ligaments were visible in groups of connections between the anterior talofibular ligament and the peroneal tendon sheath (p < 0.001) as well as the calcaneofibular ligament and the posterior tibiofibular ligament (p < 0.05), superior peroneal retinaculum (p < 0.001), and peroneal tendon sheath (p < 0.001). Differences between the thickness of the anterior talofibular ligament and the calcaneofibular ligament (p < 0.001), the diameter of the fibular insertion of the anterior talofibular ligament (p < 0.001), the diameter of calcaneal attachment of the calcaneofibular ligament (p < 0.05), and tibiocalcaneal angle (p < 0.01) were statistically significant. The presence of the double fascicular anterior talofibular ligament and the calcaneofibular ligament fascicles correlate with connections to adjacent structures.

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Section: Discussionmentioning

confidence: 88%

Section: Iermentioning

confidence: 99%

See 1 more Smart Citation

The double fascicular variations of the anterior talofibular ligament and the calcaneofibular ligament correlate with interconnections between lateral ankle structures revealed on magnetic resonance imaging

Szaro

Gataa

Polaczek

et al. 2020

Sci Rep

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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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“…The surgeon must be careful not to dissect the footprint of the inferior limb of the ATFL because it usually connects with calcaneofibular ligament (CFL) footprint. [21][22][23] Step 5: Suture Anchor Placement and ATFL Remnant Repair…”

Section: Step 4: Tunnel Creationmentioning

confidence: 99%

Anatomical Arthroscopic Anterior Talofibular Ligament Repair and Reconstruction Using a Free Tendon

Higashiyama

Sekiguchi

Takata

et al. 2020

Arthroscopy Techniques

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Arthroscopic techniques for anterior talofibular ligament (ATFL) repair and reconstruction have been developed in recent years. We simultaneously performed anatomical arthroscopic ATFL repair and reconstruction using a free tendon graft. The ATFL remnant is carefully dissected only at the footprint of the superior limb of the ATFL, and a bone tunnel is created on each side of the fibula and talus. A soft suture anchor with 2 sets of threads is inserted into the fibular tunnel. One set of threads is used to grab the ATFL remnant via a lasso-loop technique, whereas the other set of threads is used to introduce the ATFL graft. The graft is first fixed with a screw in the talar tunnel. Subsequently, the ATFL remnant and the graft are tightened simultaneously by pulling the 2 sets of suture anchor threads at the fibular tunnel and are fixed with a screw. This technique provides the possible advantages of remnant preservation and promotion of load sharing by the repaired ATFL remnant and the reconstructed ATFL graft.

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Morphological features of the anterior talofibular ligament by the number of fiber bundles

Cited by 43 publications

References 17 publications

The double fascicular variations of the anterior talofibular ligament and the calcaneofibular ligament correlate with interconnections between lateral ankle structures revealed on magnetic resonance imaging

The double fascicular variations of the anterior talofibular ligament and the calcaneofibular ligament correlate with interconnections between lateral ankle structures revealed on magnetic resonance imaging

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

Anatomical Arthroscopic Anterior Talofibular Ligament Repair and Reconstruction Using a Free Tendon

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