Advertisement

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
  • 40 Downloads

Abstract

Purpose

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.

Methods

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.

Results

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°).

Conclusions

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.

Keywords

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

Notes

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.

References

  1. 1.
    Bahr R, Pena F, Shine J, Lew WD, Engebretsen L (1998) Ligament force and joint motion in the intact ankle: a cadaveric study. Knee Surg Sports Traumatol Arthrosc 6:115–121.  https://doi.org/10.1007/s001670050083 CrossRefGoogle Scholar
  2. 2.
    Bahr R, Pena F, Shine J, Lew WD, Lindquist C, Tyrdal S, Engebretsen L (1997) Mechanics of the anterior drawer and talar tilt tests. A cadaveric study of lateral ligament injuries of the ankle. Acta Orthop Scand 68:435–441.  https://doi.org/10.3109/17453679708996258 CrossRefGoogle Scholar
  3. 3.
    Breitenseher MJ, Trattnig S, Kukla C, Gaebler C, Kaider A, Baldt MM, Haller J, Imhof H (1997) MRI versus lateral stress radiography in acute lateral ankle ligament injuries. J Comput Assist Tomogr 21:280–285CrossRefGoogle Scholar
  4. 4.
    Burks RT, Morgan J (1994) Anatomy of the lateral ankle ligaments. Am J Sports Med 22:72–77.  https://doi.org/10.1177/036354659402200113 CrossRefGoogle Scholar
  5. 5.
    Dowling A, Downey B, Green R, Reddy P, Wickham J (2003) Anatomical and possible clinical relationships between the calcaneofibular ligament and peroneus brevis—a pilot study. Manual Therapy 8:170–175.  https://doi.org/10.1016/s1356-689x(03)00015-8 CrossRefGoogle Scholar
  6. 6.
    Farooki S, Sokoloff RM, Theodorou DJ, Trudell DJ, Clopton P, Feng SA, Resnick D (2002) Visualization of ankle tendons and ligaments with MR imaging: influence of passive positioning. Foot Ankle Int 23:554–559.  https://doi.org/10.1177/107110070202300613 CrossRefGoogle Scholar
  7. 7.
    Fong DT, Ha SC, Mok KM, Chan CW, Chan KM (2012) Kinematics analysis of ankle inversion ligamentous sprain injuries in sports: five cases from televised tennis competitions. Am J Sports Med 40:2627–2632.  https://doi.org/10.1177/0363546512458259 CrossRefGoogle Scholar
  8. 8.
    Fong DT, Hong Y, Shima Y, Krosshaug T, Yung PS, Chan KM (2009) Biomechanics of supination ankle sprain: a case report of an accidental injury event in the laboratory. Am J Sports Med 37:822–827.  https://doi.org/10.1177/0363546508328102 CrossRefGoogle Scholar
  9. 9.
    Golano P, Vega J, de Leeuw PA, Malagelada F, Manzanares MC, Gotzens V, van Dijk CN (2010) Anatomy of the ankle ligaments: a pictorial essay. Knee Surg Sports Traumatol Arthrosc 18:557–569.  https://doi.org/10.1007/s00167-010-1100-x CrossRefGoogle Scholar
  10. 10.
    Kristianslund E, Bahr R, Krosshaug T (2011) Kinematics and kinetics of an accidental lateral ankle sprain. J Biomech 44:2576–2578.  https://doi.org/10.1016/j.jbiomech.2011.07.014 CrossRefGoogle Scholar
  11. 11.
    Nigg BM, Skarvan G, Frank CB, Yeadon MR (1990) Elongation and forces of ankle ligaments in a physiological range of motion. Foot Ankle 11:30–40CrossRefGoogle Scholar
  12. 12.
    Niitsu M, Ikeda K, Fukubayashi T, Anno I, Itai Y (1996) Knee extension and flexion: MR delineation of normal and torn anterior cruciate ligaments. J Comput Assist Tomogr 20:322–327CrossRefGoogle Scholar
  13. 13.
    Otsubo H, Akatsuka Y, Takashima H, Suzuki T, Suzuki D, Kamiya T, Ikeda Y, Matsumura T, Yamashita T, Shino K (2016) MRI depiction and 3D visualization of three anterior cruciate ligament bundles. Clin Anat.  https://doi.org/10.1002/ca.22810 Google Scholar
  14. 14.
    Ozeki S, Kitaoka H, Uchiyama E, Luo ZP, Kaufman K, An KN (2006) Ankle ligament tensile forces at the end points of passive circumferential rotating motion of the ankle and subtalar joint complex. Foot Ankle Int 27:965–969.  https://doi.org/10.1177/107110070602701117 CrossRefGoogle Scholar
  15. 15.
    Prins JG (1978) Diagnosis and treatment of injury to the lateral ligament of the ankle. A comparative clinical study. Acta Chir Scand Suppl 486:3–149Google Scholar
  16. 16.
    Raheem OA, O’Brien M (2011) Anatomical review of the lateral collateral ligaments of the ankle: a cadaveric study. Anat Sci Int 86:189–193.  https://doi.org/10.1007/s12565-011-0109-7 CrossRefGoogle Scholar
  17. 17.
    Renstrom P, Wertz M, Incavo S, Pope M, Ostgaard HC, Arms S, Haugh L (1988) Strain in the lateral ligaments of the ankle. Foot Ankle 9:59–63CrossRefGoogle Scholar
  18. 18.
    Takashima H, Takebayashi T, Shishido H, Yoshimoto M, Imamura R, Akatsuka Y, Terashima Y, Fujiwara H, Nagae M, Kubo T, Yamashita T (2016) Comparison with magnetic resonance three-dimensional sequence for lumbar nerve root with intervertebral foramen. Asian Spine J 10:59–64.  https://doi.org/10.4184/asj.2016.10.1.59 CrossRefGoogle Scholar

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

Personalised recommendations