Connecting fibers between ATFL's inferior fascicle and CFL transmit tension between both ligaments

被引:28
作者
Cordier, Guillaume [1 ,2 ]
Nunes, Gustavo Araujo [2 ,3 ,4 ]
Vega, Jordi [2 ,4 ,5 ]
Roure, Francesc [6 ]
Dalmau-Pastor, Miki [2 ,4 ]
机构
[1] Clin Sport Bordeaux Merignac, Chirurg Sport, 2 Rue Negrevergne, F-33700 Merignac, France
[2] MIFAS Grecmip Minimally Invas Foot & Ankle Soc, Merignac, France
[3] Hosp Santa Luzia Rede DOr, Brasilia, DF, Brazil
[4] Univ Barcelona, Sch Med & Hlth Sci, Dept Pathol & Expt Therapeut, Human Anat Unit, Barcelona, Spain
[5] Hosp Quiron Barcelona, Foot & Ankle Unit, IMove Tres Torres, Barcelona, Spain
[6] Univ Politecn Cataluna, Dept Resistencia Mat & Estruct Engn, Escola Tecn Super Engn Ind, Barcelona, Spain
关键词
Anatomy; Ankle; Ankle lateral ligaments; Anterior talofibular ligament; Calcaneofibular ligament; Lateral ligament repair; ANTERIOR TALOFIBULAR LIGAMENT; CHRONIC ANKLE INSTABILITY; ANATOMY; REPAIR;
D O I
10.1007/s00167-021-06496-w
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose The lateral ligament complex of the ankle has been extensively studied. Recently an anatomical study described a connection between anterior talofibular ligament inferior fascicle (ATFLif) and calcaneofibular ligament (CFL). The applicability and the mechanical role of these connections have not yet been studied and need to be clarified. The purpose of this study is to evaluate the connection between ATFLif and CFL through a dynamic measurement analysis. Methods An anatomical study was performed in 13 fresh-frozen below-the-knee ankle specimens. Each specimen was dissected in a protocolized manner until the lateral ligaments were exposed. A complete injury to both ATFL's fascicles was created in the proximal third of the ligament. A displacement transducer specifically design was inserted in the CFL and in the lateral part of the calcaneus to test its lengthening. A traction of 1 kg weight (9.8 N) was applied to ATFLif while the transducer measured the lengthening that this force created in the CFL. Results A total of 13 ankle specimens were carefully dissected. One specimen with signals of a prior traumatic injury of the ATFLif was excluded. A total of 12 specimens were included, 7 females and 5 males with an average age of 74 years (52-88 years). The right ankle was dissected in 6 specimens. ATFL was identified as a two-fascicled ligament in all cases. The fibers connecting the ATFLif and CFL were observed in all specimens. The displacement transducer showed lengthening in the CFL in all measurements with a median of 0.59 mm (SD +/- 0.34). Conclusion Connecting fibers between ATFLif and CFL are robust enough to transmit tension from one structure to the other. In the case of associated proximal lesions of the ATFLif and CFL, ligaments repair with a single suture may be considered. This can be applied in surgical procedures in patients with lateral ankle instability.
引用
收藏
页码:2511 / 2516
页数:6
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