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. 2022 Feb;44(2):253-259.
doi: 10.1007/s00276-021-02851-1. Epub 2021 Nov 5.

Relationship between inferior fascicle of anterior talofibular ligament and articular capsule in lateral ankle ligament complex

Akira Kakegawa  1   2 , Nanae Fukushima  3 , Norimi Sumitomo  3 , Ayata Nagira  3 , Yuko Ichinose  3 , Tetsuji Moriizumi  3
Affiliations

Relationship between inferior fascicle of anterior talofibular ligament and articular capsule in lateral ankle ligament complex

Akira Kakegawa et al. Surg Radiol Anat. 2022 Feb.

Abstract

Purpose: The lateral ankle ligament complex (LALC) is composed of anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular (PTFL) ligaments, all of which have a connection/continuous fiber. However, the structural link between the LALC and the articular capsule remains unknown. The goal of our study was to determine the connection between ATFL's inferior fascicle and the articular capsule.

Methods: In this study, we utilized 84 formalin-fixed ankles to elucidate the structure of LALC. Between ATFL and CFL, the bundle number of ATFL and arciform fiber was investigated. The specimens were decalcified and sectioned coronally using a freezing microtome, in the case of double bundles of ATFL, to study the connection between the inferior fascicle of ATFL and the articular capsule.

Results: ATFL had a single (25%), double (74%), and triple (1%) bundle number, respectively. The arciform fiber connecting the ATFL and the CFL was found in the superficial layer of all ankles (100%). There were two types of relationships between the inferior fascicle of ATFL and the articular capsule: 36 ankles (58%) were extracapsular, and 26 of 62 ankles (42%) were integrated with the inferior-lateral articular capsule. There are two kinds of relationships between the inferior fascicle of the ATFL and the articular capsule: extracapsular and integrated-capsular.

Conclusions: The inferior fascicle of ATFL has a variant and integrated-capsular type is reinforced inferior-lateral articular capsule and enters the joint to form continuous fibers with PTFL, making LALC. These anatomical findings are helpful in ultrasonography diagnosis and arthroscopic ankle surgery.

Keywords: Ankle anatomy; Anterior talofibular ligament (ATFL); Articular capsule; Inferior fascicle; Lateral ankle ligament complex (LALC).

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References

    1. Burks RT, Morgan J (1994) Anatomy of the lateral ankle ligaments. Am J Sports Med 22(1):72–77. https://doi.org/10.1177/036354659402200113 - DOI - PubMed
    1. Clanton TO, Campbell KJ, Wilson KJ, Michalski MP, Goldsmith MT, Wijdicks CA, Laprade RF (2014) Qualitative and quantitative anatomic investigation of the lateral ankle ligaments for surgical reconstruction procedures. J Bone Joint Surg Am 96(12):e98. https://doi.org/10.2106/JBJS.M.00798 - DOI - PubMed
    1. Cordier G, Nunes GA, Vega J, Roure F, Dalmau-Pastor M (2021) Connecting fibers between ATFL’s inferior fascicle and CFL transmit tension between both ligaments. Knee Surg Sports Traumatol Arthrosc 29:2511–2516. https://doi.org/10.1007/s00167-021-06496-w - DOI - PubMed
    1. Dalmau-Pastor M, Malagelada F, Calder J, Manzanares MC, Vega J (2020) The lateral ankle ligaments are interconnected: the medial connecting fibers between the anterior talofibular, calcaneofibular and posterior talofibular ligaments. Knee Surg Sports Traumatol Arthrosc 28(1):34–39. https://doi.org/10.1007/s00167-019-05794-8 - DOI - PubMed
    1. Edama M, Kageyama I, Kikumoto T, Nakamura M, Ito W, Nakamura E, Hirabayashi R, Takabayashi T, Inai T, Onishi H (2018) Morphological features of the anterior talofibular ligament by the number of fiber bundles. Ann Anat 216:69–74. https://doi.org/10.1016/j.aanat.2017.11.001 - DOI - PubMed

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