Posterior Ankle Arthroscopy and Endoscopy

Leeuw, Peter A. J. de; Sterkenburg, Maayke N. van; Bergen, Christiaan J. A. van; Dijk, C. Niek van

doi:10.1007/978-0-85729-609-2_39

Cited by 1 publication

(1 citation statement)

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“…Defining and understanding human anatomy is important for adequate, safe and reproducible surgery without iatrogenic damage to our patients [4, 6, 7]. A specific anatomical hindfoot structure has become apparent since the introduction of the hindfoot endoscopy by van Dijk et al [17].…”

Section: Introductionmentioning

confidence: 99%

The posterior fibulotalocalcaneal ligament complex: a forgotten ligament

Leeuw

Vega

Karlsson

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of the present anatomical study was to define the exact morphology of the posterior fibulotalocalcaneal ligament complex (PFTCLC), both for a better orientation and understanding of the anatomy, especially during hindfoot endoscopy. Methods Twenty-three fresh frozen specimens were dissected in order to clarify the morphology of the PFTCLC. Results In all specimens, the ligament originated from the posteromedial border of the lateral malleolus between the posterior tibiofibular ligament (superior border) and the calcaneofibular ligament (CFL), (inferior border). This origin functions as the floor for the peroneal tendon sheath. The origin of the PFTCLC can be subdivided into two parts, a superior and inferior part. The superior part forms an aponeurosis with the superior peroneal retinaculum and the lateral septum of the Achilles tendon. From this structure, two independent laminae can be identified. The inferior part of the origin has no role in the aponeurosis and ligamentous fibres run obliquely to insert in the lateral surface of the calcaneus, in the same orientation as the CFL, but slightly more posterior, which was a consistent finding in all examined specimens. The PFTCLC is maximally tensed with ankle dorsiflexion and is located within the fascia of the deep posterior compartment of the leg. Conclusions The PFTCLC is part of the normal anatomy of the hindfoot and therefore should be routinely recognized and partly released to achieve access to the posterior ankle anatomical pathology, relevant for hindfoot endoscopy. The origin of the ligament complex forms the floor for the peroneal tendon sheath. The superior part of the origin plays a role in the formation of an aponeurosis with the superior peroneal retinaculum and the lateral septum of the Achilles tendon.

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