Department of Orthopedics, Centro Hospitalar Tondela - Viseu, Viseu, Portugal.
Department of Orthopedics, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal.
Foot Ankle Surg. 2021 Apr;27(3):296-300. doi: 10.1016/j.fas.2020.06.005. Epub 2020 Jun 15.
Ankle injuries are one of the most common musculoskeletal disorder. The purpose of this study was to analyze and describe the detailed anatomical arrangement and relationship of posterior ligaments of the ankle, especially de posteroinferior tibiofibular ligament (PITFL) and intermalleolar ligament (IML). Controversy exists in the previous literature regarding their morphology and denomination, as well as the relation with ankle injuries including posterior soft tissue impingement syndrome.
Seventeen fresh-frozen cadaveric feet were used. The origins, insertions, ligament lengths, orientations with respect to relevant bony landmarks of the PITFL were evaluated.
PITFL was present in all anatomical specimens. It was formed by two independent components, the superficial and deep fibers. Their dimensions vary widely between specimens. The IML was located between the deep PITFL and posterior talofibular ligament. The shape varied from a thin fibrous band to a thick cordlike structure. The IML was evident in 82.4% of the ankles. In 28.6% of the cases, the posterior intermalleolar ligament was split into two bundles in the fibular insertion. In 14 ankles, three slips were found.
Given the frequency of injury and increasing necessity for surgical intervention, a more comprehensive anatomic knowledge of the different ligaments is warranted, provide clinically pertinent quantitative data and improve the treatment of these lesions.
踝关节损伤是最常见的肌肉骨骼疾病之一。本研究旨在分析和描述踝关节后韧带的详细解剖结构和关系，尤其是后下胫腓联合韧带（PITFL）和踝间后韧带（IML）。既往文献中关于它们的形态和命名以及与包括后软组织撞击综合征在内的踝关节损伤的关系存在争议。
使用 17 个新鲜冷冻的足标本。评估了 PITFL 的起点、止点、韧带长度以及相对于相关骨标志的方向。
PITFL 存在于所有解剖标本中。它由两个独立的成分组成，即浅层纤维和深层纤维。它们的尺寸在标本之间差异很大。IML 位于深层 PITFL 和后距腓韧带之间。形状从细纤维带到厚索状结构不等。IML 在 82.4%的踝关节中可见。在 28.6%的情况下，后踝间韧带在腓骨止点处分为两束。在 14 个踝关节中发现了三个分支。
鉴于损伤的频率和对手术干预的日益需求，需要更全面地了解不同的韧带的解剖结构，提供更有临床意义的定量数据，并改善这些病变的治疗效果。
