Bilyy Andrey, Win Mar Wai Wai, Al Abdeen Al Zuabi Zain, Frimpong-Manso Honey B, Famure Steven, Solomou Georgios, Brassett Cecilia, Pasapula Chandra
Plastic and Reconstructive Surgery, Chelsea and Westminster Hospital, London, GBR.
Orthopaedics, Queen Elizabeth Hospital King's Lynn, King's Lynn, GBR.
Cureus. 2025 Apr 4;17(4):e81715. doi: 10.7759/cureus.81715. eCollection 2025 Apr.
The aim of this study is to review the variation in description of the individual bands comprising the deltoid and spring ligaments in anatomical dissection studies and to propose a novel approach to describe the structure. A literature search for cadaveric studies identifying anatomical variations in the deltoid and spring ligament complexes was conducted using PubMed and Medline databases. The inclusion criteria encompassed human cadaveric dissection studies with measurement of individual deltoid and spring ligament bands in the English language and with full-text availability. The following studies were excluded: animal studies, articles describing surgical repair approaches, and radiological assessment studies without cadaveric dissection. The demographic data, parameters of individual components, as well as the morphological structure of individual deltoid bands were summarised. Out of the 18,208 studies from the database search, 11 articles were included in this study. Thirteen additional studies were obtained from the bibliographies, resulting in a total of 24 studies with 528 ankles evaluated. Due to the complexity of their anatomical relationships, the deltoid and spring ligaments should be described as a single entity: the "deltoid-spring ligament complex". Its gross morphology can be described as triangular, trapezoidal, and rectangular. It can be differentiated into the deep deltoid and the superficial deltospring ligament, which are connected. The latter encompasses the superficial deltoid and superomedial part of the spring ligament. The deep plantar ligament and "the inferior spring ligament" are separate entities reflecting their discrete natures and histological differences. The superficial deltospring ligament can be divided into contiguous segments with variable bands (thickening but not true ligaments). Each segment can be clinically assessed en masse. This description can help to clarify the nomenclature.
本研究的目的是回顾解剖学研究中对构成三角韧带和跟舟韧带的各个束带的描述差异，并提出一种描述该结构的新方法。使用PubMed和Medline数据库对尸体研究进行文献检索，以确定三角韧带和跟舟韧带复合体的解剖变异。纳入标准包括以英语撰写且有全文的人体尸体解剖研究，这些研究测量了三角韧带和跟舟韧带的各个束带。排除以下研究：动物研究、描述手术修复方法的文章以及无尸体解剖的放射学评估研究。总结了人口统计学数据、各个组成部分的参数以及三角韧带各束带的形态结构。在数据库搜索得到的18208项研究中，本研究纳入了11篇文章。从参考文献中又获取了13项研究，最终共有24项研究，评估了528个踝关节。由于其解剖关系复杂三角韧带和跟舟韧带应被描述为一个单一实体：“三角 - 跟舟韧带复合体”。其大体形态可描述为三角形、梯形和矩形。它可分为相连的深层三角韧带和浅层三角跟舟韧带。后者包括浅层三角韧带和跟舟韧带的上内侧部分。深层跖韧带和“下跟舟韧带”是独立的实体，反映了它们不同的性质和组织学差异。浅层三角跟舟韧带可分为具有不同束带（增厚但并非真正韧带）的连续节段。每个节段可进行整体临床评估。这种描述有助于明确命名法。
