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Dimensions and attachments of the ankle ligaments: evaluation for ligament reconstruction

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Abstract

For operative reconstruction, precise anatomic information on the dimensions of the ankle ligaments is important and can help to optimize these procedures. The purpose of this study was to investigate the length and width dimensions of the ankle ligaments and to contrast the results with the published literature. Seventeen non-paired adult, formalin-fixed ankle specimen were dissected to expose the capsuloligamentous structures. The following ligaments were investigated: tibiofibular syndesmosis (anterior and posterior tibiofibular ligament/ATiFL and PTiFL), lateral ankle ligaments (anterior and posterior talofibular ligament, calcaneofibular ligament/ATFL, PTFL and CFL), medial ankle ligaments (deltoid ligament, anterior and posterior tibiotalar ligament/ATTL and PTTL). After identification of the ligaments, the dimensions were measured with a ruler and a sliding caliper. Additionally, the attachment area and the center of insertion (COI) were evaluated. The dimensions of the ligaments were recorded. Measurements were calculated and discussed according to the existing literature. The tibial COI of the ATiFL was situated 8.35 ± 2.05 mm from the inferior articular surface of the tibia and 5.04 ± 1.32 mm from the fibular notch. Its fibular COI was situated 25.45 ± 5.84 mm from the tip of the lateral malleolus and 3.12 ± 1.01 mm from the malleolar articular surface. The calcaneal COI of the CFL was situated 20.63 ± 3.56 mm anterior and 5.73 ± 1.89 mm plantar to the superior edge of the calcaneal. Its fibular attachment of the CFL was directly at the tip of the lateral malleolus, dorsal to the fibular attachment of the ATFL. Studies of the therapeutic options in severe ankle ligament injuries have shown better results in anatomical reconstructions compared to other operative treatments. To optimize these procedures, exact anatomical information on the dimensions of the ankle ligaments should be beneficial.

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Acknowledgements

The authors would like to remember the donors and thank their families. Without their selfless contribution our work would not be possible.

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The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Surgery, University Hospital of Basel, Basel, Switzerland

    Raphael Wenny

  2. Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA

    Dominik Duscher

  3. Orthopedic Hospital Speising, Vienna, Austria

    Patrick Weninger

  4. Department for Systematic Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Währingerstraße 13, 1090, Vienna, Austria

    Raphael Wenny, Dominik Duscher, Emmy Meytap & Lena Hirtler

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  1. Raphael Wenny
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  2. Dominik Duscher
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Correspondence to Lena Hirtler.

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Wenny, R., Duscher, D., Meytap, E. et al. Dimensions and attachments of the ankle ligaments: evaluation for ligament reconstruction. Anat Sci Int 90, 161–171 (2015). https://doi.org/10.1007/s12565-014-0238-x

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