Chen Zhimin, Yang Han, Zhang Xuequan, Su Minghao, Li Zeyu, Liu Chang, Xiao Zhaoming, Liang Hiabin, Xu Guangwei, Xu Chujiang, Ouyang Jun, Dai Jingxing
Department of Imaging Diagnostics, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
BMC Musculoskelet Disord. 2025 May 6;26(1):445. doi: 10.1186/s12891-025-08699-5.
The purpose of this study was to obtain anatomical information on the anterior talofibular ligament (ATFL), anterior tibiofibular ligament (ATiFL) and calcaneofibular ligament (CFL) in the neutral position and during plantar flexion.
Seventy specimens with whole ankle ligaments were recorded for anatomy education. ATFLs with single, double, and triple bands corresponded to Types A, B, and C. In our study, different types of ATFLs with information on the length, width, ATFL/CFL angle, ATFL/ATiFL angle, and the distance of the fibular center of insertion (fCOI) of ATFL-CFL-ATiFL in the neutral position and 20° plantar flexion, was collected.
In Type B, the length, width, and ATFL/ATiFL angle of the superior and inferior bands varied (length, P < 0.001; width, P < 0.001; ATFL/ATiFL angle, P < 0.001). Among the types, the total widths of Types A/B and A/C were significantly different (P < 0.01; P < 0.001). In terms of postural changes, significant differences in the ATFL/ATiFL angle were observed for Type A (P < 0.001), Type B (P < 0.001), and Type C (P < 0.01).
In conclusion, attention should be given to the ATFL widths of different ATFL types during surgical treatment because of the significant differences among the three ATFL types. The relative independence of ATiFL and the cooperative relationship between ATFL and CFL are instructive for different ATFL surgical procedures. The ATFL, CFL, and ATiFL data can be used for anatomical reconstruction and secondary proofreading for ATFL injury or chronic ankle instability.
本研究旨在获取距腓前韧带（ATFL）、胫腓前韧带（ATiFL）和跟腓韧带（CFL）在中立位和跖屈位时的解剖学信息。
记录70例带有完整踝关节韧带的标本用于解剖学教学。单束、双束和三束的ATFL分别对应A、B和C型。在本研究中，收集了不同类型ATFL在中立位和跖屈20°时的长度、宽度、ATFL/CFL角度、ATFL/ATiFL角度以及ATFL - CFL - ATiFL的腓骨插入中心（fCOI）距离等信息。
在B型中，上下束的长度、宽度和ATFL/ATiFL角度存在差异（长度，P < 0.001；宽度，P < 0.001；ATFL/ATiFL角度，P < 0.001）。在各类型之间，A/B型和A/C型的总宽度存在显著差异（P < 0.01；P < 0.001）。在姿势变化方面，A、B、C型的ATFL/ATiFL角度均存在显著差异（A，P < 0.001；B，P < 0.001；C，P < 0.01）。
总之，由于三种ATFL类型之间存在显著差异，手术治疗时应关注不同ATFL类型的宽度。ATiFL的相对独立性以及ATFL与CFL之间的协同关系对不同的ATFL手术操作具有指导意义。ATFL、CFL和ATiFL的数据可用于ATFL损伤或慢性踝关节不稳的解剖重建和二次校对。
