Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments

Category: Basic Sciences/Biologics; Ankle Introduction/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 applica...

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Main Authors: Gustavo A. Nunes MD, Miki Dalmau-Pastor PhD, Jordi Vega, Guillame Cordier
Format: Article
Language:English
Published: SAGE Publishing 2022-11-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011421S00855
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author Gustavo A. Nunes MD
Miki Dalmau-Pastor PhD
Jordi Vega
Guillame Cordier
author_facet Gustavo A. Nunes MD
Miki Dalmau-Pastor PhD
Jordi Vega
Guillame Cordier
author_sort Gustavo A. Nunes MD
collection DOAJ
description Category: Basic Sciences/Biologics; Ankle Introduction/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.
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spelling doaj.art-cc05a9df0f724bdca862eef2796aa5762022-12-22T04:14:39ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142022-11-01710.1177/2473011421S00855Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both LigamentsGustavo A. Nunes MDMiki Dalmau-Pastor PhDJordi VegaGuillame CordierCategory: Basic Sciences/Biologics; Ankle Introduction/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.https://doi.org/10.1177/2473011421S00855
spellingShingle Gustavo A. Nunes MD
Miki Dalmau-Pastor PhD
Jordi Vega
Guillame Cordier
Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments
Foot & Ankle Orthopaedics
title Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments
title_full Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments
title_fullStr Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments
title_full_unstemmed Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments
title_short Connecting Fibers Between ATFL's Inferior Fascicle and CFL Transmit Tension Between Both Ligaments
title_sort connecting fibers between atfl s inferior fascicle and cfl transmit tension between both ligaments
url https://doi.org/10.1177/2473011421S00855
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