Variations of three lateral ligaments of the ankle. A descriptive anatomical study

Abstract

The aim of this investigation was to study the intra- and inter-individual variations in the anatomy of the lateral ligaments of the ankle. 44 fixed cadaver ankles were used. In 73%, intra-individual variations were found, varying from 1 to 5 anatomical characteristics. The calcaneofibular ligament (CFL) showed intra-individual variations in 66.6%, the anterior talofibular ligament (ATFL) in 33.3% and the lateral talocalcaneal ligament (LTCL) in 46.6%. The angular relationship between the ATFL and CFL showed intra-individual variations in 40%. The three ligamentous structures studied showed inter-individual variations. The ATFL showed a single ligamentous structure in 68% and two separate bundles in 32%. The CFL showed the most variations in size, shape, orientation and capsular relation. A solid, cordlike structure was seen in 66% and a flat and fanning out structure in 34%. The CFL was identified as an extracapsular structure in 68% and as a capsular reinforcement in 32%. It is suggested that intra-individual variations in the angular relationship between the ATFL and CFL should be kept in mind when basing diagnosis of lesions of the lateral ligaments of the ankle on right-left comparison.