Abstract:Injuries to the lateral ligament complex of the ankle are common problems in acute care practice. We believe that a well-developed knowledge of the anatomy provides a foundation for understanding the basic mechanism of injury, diagnosis, and treatment, especially surgical treatment, of lateral collateral ankle ligament injury. To address this issue we performed this review with regard to the anatomy of the lateral collateral ankle ligaments.
“…1). This ligament plays an important role in limiting anterior displacement of the talus and plantar flexion of the ankle [40]. Fig.…”
Section: Lateral Collateral Ligamentsmentioning
confidence: 99%
“…The center is on average 10 mm proximal to the tip of the fibula as measured along the axis of the fibula [10]. The overall width (6–10 mm) of the anterior tibiotalar ligament does not appear to vary greatly irrespective of the number of bands present, suggesting that the variations observed do not modify the ligament’s function [40] (Figs. 3, 4).…”
Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail.
“…1). This ligament plays an important role in limiting anterior displacement of the talus and plantar flexion of the ankle [40]. Fig.…”
Section: Lateral Collateral Ligamentsmentioning
confidence: 99%
“…The center is on average 10 mm proximal to the tip of the fibula as measured along the axis of the fibula [10]. The overall width (6–10 mm) of the anterior tibiotalar ligament does not appear to vary greatly irrespective of the number of bands present, suggesting that the variations observed do not modify the ligament’s function [40] (Figs. 3, 4).…”
Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail.
“…6,7 The
anterior talofibular ligament (ATFL) is the main lateral stabiliser
of the ankle joint and is most commonly affected first, followed
by the calcaneofibular ligament (CFL) and the posterior talofibular
ligament (PTFL). 8,9 In cases where surgery
is considered for symptomatic CAI, it is imperative not only to
detect injured lesions but also to document the extent of ligament
tear and the quantity of residual ligamentous tissue, as anatomic
repair is recommended when the quality of the ruptured ligaments
permits, and anatomic reconstruction should be performed when ligaments
are attenuated. 10,11 Although various
imaging techniques such as stress radiography and MRI have been
used for diagnosis, 12-15 few studies have
examined the sensitivities of evaluation methods in providing information
about residual ligamentous tissue.…”
ObjectivesTo evaluate the applicability of MRI for the quantitative assessment
of anterior talofibular ligaments (ATFLs) in symptomatic chronic
ankle instability (CAI).MethodsBetween 1997 and 2010, 39 patients with symptomatic CAI underwent
surgical treatment (22 male, 17 female, mean age 25.4 years (15
to 40)). In all patients, the maximum diameters of the ATFLs were
measured on pre-operative T2-weighted MR images in planes parallel
to the path of the ATFL. They were classified into three groups based
on a previously published method with modifications: ‘normal’, diameter
= 1.0 - 3.2 mm; ‘thickened’, diameter > 3.2 mm; ‘thin or absent’,
diameter < 1.0 mm. Stress radiography was performed with the
maximum manual force in inversion under general anaesthesia immediately
prior to surgery. In surgery, ATFLs were macroscopically divided
into two categories: ‘thickened’, an obvious thickened ligament
and ‘thin or absent’. The imaging results were compared with the
macroscopic results that are considered to be of a gold standard.ResultsAgreement was reached when comparison was made between groups,
based on MRI and macroscopic findings. ATFLs were abnormal in all
39 cases and classified as ten ‘thickened’ and 29 ‘thin or absent’.
As to talar tilt stress radiography, a clear cut-off angle, which
would allow discrimination between ‘thickened’ and ‘thin or absent’ patients,
was not identified.ConclusionMRI is valuable as a pre-operative assessment tool that can provide
the quantitative information of ATFLs in patients with CAI.Cite this article Bone Joint Res 2014;3:241–5.
“…30,31 The anatomic orientation of the ATFL shows how the ATFL functions to restrict plantar flexion and inversion and how it is vulnerable during a forced inversion of the ankle. 32 This study employed US at this end range of motion to image the ATFL during positions where it is vulnerable to injury. The increased talofibular interval observed is likely due to the plantar-flexed positioning combined with the internal rotation of the talus, a motion that the ATFL should restrain when intact.…”
Stress US methods identified increased talofibular interval changes suggestive of talocrural laxity and ATFL injury using anterior drawer and inversion stress that, despite significant improvements in self-reported function, only marginally improved during the 6 wk after ankle sprain. Stress US provides a safe, repeatable, and quantifiable method of measuring the talofibular interval and may augment manual stress examinations in acute ankle injuries.
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