Morphometric relationships between dimensions the anterior talofibular ligament and calcaneofibular ligament in routine magnetic resonance imaging

Pawel Szaro,Przemysław Pękala,Khaldun Ghali Gataa,Nektarios Solidakis

doi:10.1186/s40634-021-00406-2

Abstract

PurposeThis study aimed to test the hypothesis that routine MRI ankle can be used to evaluate dimensions and correlations between dimensions of single and double fascicular variants of the ATFL and the CFL.MethodsWe reviewed ankle MRIs for 251 patients. Differences between the length, thickness, width, and length of the bony attachments were evaluated twice. P < .05 was considered as significant.ResultsFor the ATFL, we observed a negative correlation between thickness and width, with a positive correlation between thickness and length (p < 0.001). The average values for the ATFL were thickness, 2.2 ± 0.05 mm; length, 21.5 ± 0.5 mm; and width, 7.6 ± 0.6 mm. The average values for the CFL were thickness, 2.1 ± 0.04 mm; length, 27.5 ± 0.5 mm; and width, 5.6 ± 0.3 mm. A negative correlation was found between length and width for the CFL (p < 0.001).ConclusionsRoutine MRI showed that most dimensions of the ATFL and CFL correlate with each other, which should be considered when planning new reconstruction techniques and developing a virtual biomechanical model of the human foot.Level of evidenceIII

Highlights

The ankle instability and pain after surgical ligament reconstruction is seen in about 20% of patients, which requires further treatment [1]
This study aimed to investigate the clinical anatomy of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) and their mutual relationship
The anterior talofibular ligament The intra-observer agreement was measured by interclass correlation coefficients (ICC) values which ranged from 0.58 to 0.89 for individual measurements (Table 1) while the inter-observer agreement ranged from 0.41 to 0.70 (Table 2)

Summary

Introduction

The ankle instability and pain after surgical ligament reconstruction is seen in about 20% of patients, which requires further treatment [1]. The graft morphology and morphometry vary depending on the surgical technique but seem to be the. Based on the published literature, the length of the ATFL can be either 13–14 mm or 21–22 mm [4, 6], which may confirm that the values depend on the methodology and probably variations in fascicular structure. The length of the CFL is reported to be 15 mm [8] to 25 mm [5]. The width of the ATFL varies between studies from 6 mm [6] to 11 mm [8], while the width of the CFL varies from 5 mm [8] to 8 mm [5]

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Conclusion