Nikolopoulos Constantinos E, Tsirikos Athanasios I, Sourmelis Savas, Papachristou Georgios
1st Orthopaedic Department, University of Athens, KAT Hospital, Athens, Greece.
Am J Sports Med. 2004 Mar;32(2):389-95. doi: 10.1177/0095399703258697.
A distal fascicle of the anteroinferior tibiofibular ligament has been reported as a possible cause of anterolateral ankle impingement.
This fascicle represents an independent accessory ligament in the anterior aspect of the inferior tibiofibular syndesmosis.
Descriptive anatomical study.
The inferior tibiofibular syndesmosis was exposed in 24 fresh-frozen cadaveric ankles. Morphological characteristics of the inferior tibiofibular ligaments and interactions between the anterior ligaments and the talus were investigated in different degrees of ankle motion.
A separate accessory anterior ligament was identified in 22 specimens. Its orientation was parallel and distal to the anterior tibiofibular ligament, from which it was separated by a fibrofatty septum. Its length ranged from 17 to 22 mm, its thickness from 1 to 2 mm, and its width from 3 to 5 mm. Impingement of this ligament against the talar dome was documented in all specimens in neutral ankle position, with bending of the ligamentous bands in dorsiflexion. Distraction maneuvers reproducing traction during arthroscopic approaches relieved contact.
An accessory anteroinferior tibiofibular ligament with distinct anatomical features was recognized.
Based on its increased incidence in the cadaver ankles, the accessory ligament reflects a normal anatomical finding. Nevertheless, it could lead to anterolateral impingement in cases with coexistent ankle instability.
据报道，胫腓下前韧带的远侧束可能是踝关节前外侧撞击的一个原因。
该束代表胫腓下联合前方的一条独立副韧带。
描述性解剖学研究。
在24个新鲜冷冻尸体踝关节上暴露胫腓下联合。在不同程度的踝关节活动中，研究胫腓下韧带的形态特征以及前侧韧带与距骨之间的相互作用。
在22个标本中发现了一条单独的副前韧带。其走行与胫腓前韧带平行且位于其远侧，二者被纤维脂肪间隔分开。其长度为17至22毫米，厚度为1至2毫米，宽度为3至5毫米。在踝关节中立位时，所有标本均记录到该韧带撞击距骨穹窿，背屈时韧带束弯曲。在关节镜手术中模拟牵引的牵开操作可减轻接触。
识别出了一条具有独特解剖特征的副胫腓下前韧带。
基于其在尸体踝关节中的高发生率，该副韧带反映了一种正常的解剖学发现。然而，在存在踝关节不稳的情况下，它可能导致前外侧撞击。
