Figure 1 - uploaded by Baris Yilmaz
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Lateral view of a right ankle in neutral position, showing attachment sites of single bundle of ATFL.
Source publication
Purpose
The aim of the study was to evaluate whether or not there was any incompatibility between two-strand hamstring tendons taken from the same knee and the ATFL and it was the determination of suitable footprint points in the fibula and talus for anatomical ATFL reconstruction.
Methods
16 fresh frozen cadaver specimens were dissected to gracil...
Context in source publication
Context 1
... a single bundle, the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL was averaged 14.42 (13.50 to 15.6) mm, the distance between the apex of the lateral talar process and the talus adhesion site of ATFL was averaged 11.62 (10.40 to 12.40) mm ( Figure 1). There was a moderate correlation between body height and the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL (r: 36.5 p: 0.036). ...
Similar publications
Background: Ankle fractures represent 10% of all fractures with an incidence of around 137/105 population per year. These fractures are most of the times associated with syndesmotic injuries due to rotation of the limb with foot fixed/axial loading as a result of high velocity injuries. The syndesmosis is ruptured as a result of a torsional movemen...
Citations
... 1,2,8 Recently, ATFL remnant quality has been the subject of study when defining the best approach, 2 but the ideal graft and preparation technique is yet unknown. 5 Lopes et al 7 combined arthroscopic ATFL and CFL reconstruction technique implements a 10-cm gracilis autograft, harvested using a tendon stripper through a short oblique incision, in which both ends are threaded with FiberLoop No. 2 (Arthrex, Naples, FL) and placing one of them through a 4.75-× 15-mm Bio-Tenodesis Screw system (Arthrex) for fixation to the talus. This study aims to describe a modified gracilis autograft preparation for the arthroscopic ATFL and CFL reconstruction as described by Lopes et al. 7 ...
Visual AbstractThis is a visual representation of the abstract.
Anterior talofibular ligament (ATFL) injuries are the most common cause of ankle sprains. To ensure anatomically accurate surgery and ultrasound imaging of the ATFL, anatomical knowledge of the bony landmarks around the ATFL attachment to the distal fibula is required. The purpose of the present study was to anatomically investigate the ATFL attachment to the fibula with respect to bone morphology and attachment structures. First, we analyzed 36 feet using micro-computed tomography. After excluding 9 feet for deformities, the remaining 27 feet were used for chemically debrided bone analysis and macroscopic and histological observations. Ten feet of living specimens were observed using ultrasonography. We found that a bony ridge was present at the boundary between the attachments of the ATFL and calcaneofibular ligament (CFL) to the fibula. These two attachments could be distinguished based on a difference in fiber orientation. Histologically, the ATFL was attached to the anterodistal part of the fibula via fibrocartilage anterior to the bony ridge indicating the border with the CFL attachment. Using ultrasonography in living specimens, the bony ridge and hyperechoic fibrillar pattern of the ATFL could be visualized. We established that the bony ridge corresponded to the posterior margin of the ATFL attachment itself. The ridge was obvious, and the superior fibers of the ATFL have directly attached anteriorly to it. This bony ridge could become a valuable and easy-to-use landmark for ultrasound imaging of the ATFL attachment if combined with the identification of the fibrillar pattern of the ATFL.
