Surgical and Radiologic Anatomy

, Volume 41, Issue 3, pp 307–311 | Cite as

Morphological evaluation of the calcaneofibular ligament in different ankle positions using a three-dimensional MRI sequence

  • Yoshihiro Akatsuka
  • Atsushi TeramotoEmail author
  • Hiroyuki Takashima
  • Kota Watanabe
  • Toshihiko Yamashita
Original Article



Evaluating images of the lateral ligament of the ankle is not easy, and evaluation of the calcaneofibular ligament (CFL) in particular is difficult. We prospectively conducted morphological measurements of the CFL in different ankle positions and obtain basic data for use in functional assessment of the CFL, diagnosis of CFL injury, and determination of treatment effects.


The subjects were ten healthy volunteers (ten ankles) with a mean age of 27.8 years and no history of ankle disease. Imaging was done using a 3-T magnetic resonance imaging (MRI) machine and fast imaging employing steady-state acquisition cycled phases (FIESTA-C), a three-dimensional (3D) sequence, with the ankle in a neutral position, maximum dorsiflexion, and maximum plantar flexion. 3D images of the CFL, peroneal muscle tendons, fibula, and calcaneus were prepared at a workstation, and morphological measurements of the CFL were made.


In all positions, the CFL showed a gently curving course with the peroneal muscle tendons as a fulcrum. The tortuosity angle was significantly smaller in plantar flexion (30.0° ± 7.4°) than in the neutral position (41.7° ± 8.3°).


3D MRI sequences showed that, in all positions, the CFL curved due to the influence of the peroneal muscle tendons. With maximum plantar flexion, the CFL tortuosity angle was small, which was thought to have been due to the tension in the CFL.


Calcaneofibular ligament 3D magnetic resonance imaging Ankle position Peroneal muscle tendons Morphological evaluation 


Author contributions

YA: Data collection, data analysis, manuscript writing. AT: Project development, manuscript writing. HT: Data analysis, manuscript editing. KW: Manuscript editing. TY: Manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights statement

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Yoshihiro Akatsuka
    • 1
  • Atsushi Teramoto
    • 2
    Email author
  • Hiroyuki Takashima
    • 1
  • Kota Watanabe
    • 3
  • Toshihiko Yamashita
    • 2
  1. 1.Division of Radiology and Nuclear MedicineSapporo Medical University HospitalSapporoJapan
  2. 2.Department of Orthopaedic SurgerySapporo Medical University School of MedicineSapporoJapan
  3. 3.Second Division of Physical TherapySapporo Medical University School of Health SciencesSapporoJapan

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