RESEARCH PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Common to the talocrural and subtalar joints, the calcaneofibular ligament forms with the anterior bundle a mechanical coupling factor for ankle stabilization. Adhering to the deep surface of the fibular sheath, doubled in depth by the lateral talocalcaneal ligament, it is solicited in isolated varus and its lesion is involved in subtalar instability. The therapeutic strategy for chronic ankle instability is currently based on the anatomical reconstruction of the ligaments, particularly by arthroscopy, hence the objective of this study, which aims to highlight the great variability of the calcaneofibular ligament.

Material and methods:
Our work is based on the dissection of 24 ankles. The number of beams, the dimensions at the neutral point and after power-up, the relationships with the surrounding anatomical structures as well as the points of insertion of the CFL are studied.

Results:
The calcaneofibular ligament was monofascicular in 91.6% of cases and bifascicular in 8.4%. Its average length in a neutral position was 26.85 ± 3.46 mm, and its width was 5.33 ± 1.45 mm. In dorsiflexion, the length was 27.10 ± 0.05 mm, and in forced inversion, it was 26.98 ± 0.07 mm. The distance between its fibular insertion and the apex of the lateral malleolus was 6.2 ± 0.9 mm.

Conclusions:
Injuries of the calcaneofibular ligament are common in lateral ankle sprains, which can often get complicated by chronic instability. The macroscopic and morphometric knowledge of this ligament can allow a more accurate anatomical reconstruction and a more accurate choice of graft.

Assia Yabka, Hamzaoui Bahia. Anatomical dissection of the calcaneofibular ligament of the ankle Macroscopic and morphometric study. J Pre-Clin Clin Res. 2021; 15(3): 121–125. doi: 10.26444/jpccr/140211
REFERENCES (22)
1.
Dufour M. Anatomie de l’appareil locomoteur T1. Editeur: Elsevier-Masson. 3 Juin 2015. p. 546. ISBN13: 9782294745027.
 
2.
Yıldız S, Yalcın B. The anterior talofibular and calcaneofibular ligaments: an anatomic study. Surg Radiol Anat. 2013 Aug; 35(6): 511–6. doi: 10.1007/s00276-012-1071-3. Epub 2013 Jan 5. PMID: 23292089.
 
3.
Dalmau-Pastor M, Malagelada F, Calder J, et al. The lateral ankle ligaments are interconnected: the medial connecting fibres between the anterior talofibular, calcaneofibular and posterior talofibular ligaments. Knee Surg Sports Traumatol Arthrosc. 2020 Jan; 28(1): 34–39. doi: 10.1007/s00167-019-05794-8. Epub 2019 Nov 22. PMID: 31754730.
 
4.
Vega J, Malagelada F, Manzanares Céspedes MC, et al. The lateral fibulotalocalcaneal ligament complex: an ankle stabilizing isometric structure. Knee Surg Sports Traumatol Arthrosc. 2020 Jan; 28(1): 8–17. doi: 10.1007/s00167-018-5188-8. Epub 2018 Oct 29. PMID: 30374570.
 
5.
Kakegawa A, Mori Y, Tsuchiya A, et al. Independent Attachment of Lateral Ankle Ligaments: Anterior Talofibular and Calcaneofibular Ligaments – A Cadaveric Study. J Foot Ankle Surg. 2019 Jul; 58(4): 717–722. doi: 10.1053/j.jfas.2018.12.009. Epub 2019 May 23. PMID: 31130481.
 
6.
Edama M, Kageyama I, Kikumoto T, et al. Morphological characteristics of the lateral talocalcaneal ligament: a large-scale anatomical study. Surg Radiol Anat. 2019 Jan; 41(1): 25–28. doi: 10.1007/s00276-018-2128-8 Epub 2018 Oct 30. PMID: 30377754.
 
7.
Kitsoulis P, Marini A, Pseftinakou A, et al. Morphological study of the calcaneofibular ligament in cadavers. Folia Morphol (Warsz). 2011 Aug; 70(3): 180–4. PMID: 21866529.
 
8.
Burks RT, Morgan J. Anatomy of the lateral ankle ligaments. Am J Sports Med. 1994 Jan-Feb; 22(1): 72–7. doi: 10.1177/036354659402200113 PMID: 8129114.
 
9.
Apoorva D, Lalitha C, Girish V Patil. “Morphometric Study of Calcanéo-fibular Ligament of Ankle”. Journal of Evidence based Medicine and Healthcare; Volume 1, Issue 10, November 10, 2014 Page: 1268–1274. doi : 10.18410/jebmh/2014/191.
 
10.
Matsui K, Takao M, Tochigi Y, et al. Anatomy of anterior talofibular ligament and calcaneofibular ligament for minimally invasive surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017 Jun; 25(6): 1892–1902. doi: 10.1007/s00167-016-4194-y. Epub 2016 Jun 13. PMID: 27295109.
 
11.
Thès A, Klouche S, Ferrand M, et al. Assessment of the feasibility of arthroscopic visualization of the lateral ligament of the ankle: a cadaveric study. Knee Surg Sports Traumatol Arthrosc. 2016 Apr; 24(4): 985–90. doi: 10.1007/s00167-015-3804-4. Epub 2015 Sep 26. PMID: 26410094.
 
12.
Wu X, Song W, Zheng C, et al. Morphological study of mechanoreceptors in collateral ligaments of the ankle joint. J Orthop Surg Res. 10; 92(2015). https://doi.org/10.1186/s13018....
 
13.
Al-Mohrej OA, Al-Kenani NS. Acute ankle sprain: conservative or surgical approach? EFORT Open Rev. 2017 Mar 13; 1(2): 34–44. doi: 10.1302/2058-5241.1.000010. PMID: 28461926; PMCID: PMC5367574.
 
14.
Tourné Y, Mabit C. La cheville instable, de l’entorse récente à l’instabilité chronique. Elsevier Masson. 2015.
 
15.
Pereira BS, van Dijk CN, Andrade R, et al. The calcaneofibular ligament has distinct anatomic morphological variants: an anatomical cadaveric study. Knee Surg Sports Traumatol Arthrosc. 2020 Jan; 28(1): 40–47. doi: 10.1007/s00167-019-05797-5. Epub 2019 Nov 27. PMID: 31776625.
 
16.
Szaro P, Ghali Gataa K, Polaczek M, et al. The double fascicular variations of the anterior talofibular ligament and the calcaneofibular ligament correlate with interconnections between lateral ankle structures revealed on magnetic resonance imaging. Sci Rep. 2020 Nov 27; 10(1): 20801. doi: 10.1038/s41598-020-77856-8. PMID: 33247207; PMCID: PMC7695848.
 
17.
Taser F, Shafiq Q, Ebraheim NA. Anatomy of lateral ankle ligaments and their relationship to bony landmarks. Surg Radiol Anat. 2006 Aug; 28(4): 391–7. doi: 10.1007/s00276-006-0112-1. Epub 2006 Apr 27. PMID: 16642279.
 
18.
Uğurlu M, Bozkurt M, Demirkale I, et al. Anatomy of the lateral complex of the ankle joint in relation to peroneal tendons, distal fibula and talus: a cadaveric study. Eklem Hastalik Cerrahisi. 2010 Dec; 21(3): 153–8. PMID: 21067497.
 
19.
Boulacel A. Étude morphologique et exploration de l’articulation talo-crurale chez l’homme. Thèse soutenue le 13/10/2008. Université de Constantine (ed): 2007–2008.
 
20.
Clanton TO, Campbell KJ, Wilson KJ, et al. Qualitative and Quantitative Anatomic Investigation of the Lateral Ankle Ligaments for Surgical Reconstruction Procedures. J Bone Joint Surg Am. 2014 Jun 18; 96(12): e98. doi: 10.2106/JBJS.M.00798. PMID: 24951749.
 
21.
Lopez R, Noailles T, Bouguennec N, et al. Validation anatomique d’un repérage cutané de l’insertion distale du LCF. Revue de chirurgie orthopédique et traumatologique. Volume 101, N°85. Page. 33: doi: 10.1016/j.rcot.2015.09.391.
 
22.
Park JH, Kwon HW, Kim D, et al. The Location of the Fibular Tunnel for Anatomically Accurate Reconstruction of the Lateral Ankle Ligament: A Cadaveric Study. Biomed Res Int. 2021 Mar 18; 2021: 5575524. doi: 10.1155/2021/5575524. PMID: 33791364; PMCID: PMC7997753.
 
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ISSN:1898-2395
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