ABSTRACT
Anatomic knowledge of lateral ligaments around the lateral malleolus is important
for repair or reconstruction of ankle instability. The detailed structure of the connective
fibers between the anterior talofibular ligament (ATFL) and the calcaneofibular ligament
(CFL) is unknown. To clarify the anatomic structure of ATFL and CFL and the connective
fiber between the 2 ligaments, the lateral ligament was dissected in 60 ankles of
formalin-fixed cadavers, and the distance was measured between bony landmarks and
fibular attachment of ATFL and CFL using a digital caliper. All ankles had connective
fibers between ATFL and CFL. The structure of connective fibers consisted of a thin
fiber above the surface layer of ATFL and CFL; it comprised thin fibrils of the surface
layer covering the lower part of ATFL and the front part of CFL. Both ATFL and CFL
were independent fibers, and both attachments of the fibula were isolated. Single
bands of ATFL were noted in 14 of 60 (23.3%) ankles, double bands that divided the
superior and inferior bands were observed in 42 of 60 (70.0%) ankles, and multiple
bands were observed in 4 of 60 (6.7%) ankles. A cord-like and a flat and fanning type
of CFL was noted in 22 (36.7%) and 38 (63.3%) of the 60 ankles, respectively. Distances
between ATFL/CFL and articular and inferior tips of the fibula were 4.3 ± 1.1 mm/7.6
± 1.6 mm and 14.3 ± 1.9 mm/7.4 ± 1.7 mm, respectively (mean ± standard deviation).
The results of this study suggest that knowledge of more anatomic structures of ATFL,
CFL, and connective fiber will be beneficial for surgeons in the repair or reconstruction
of the lateral ligament of the ankle.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: May 23, 2019
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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