The Anatomy And Radiography Of The Ankle Deltoid Ligaments And Its Clinical Application

Objective:To evaluate the morphous of deltoid ligaments of ankle joint and its clinicalsignificance through anatomy and radiology research, especially the stressradiography, computer tomography (CT) and magnetic resonance imaging(MRI) ofthe deltoid ligaments.Material and methods:1. Ten fresh frozen adult foot specimens with distal calf were stabilized in foamedplastics frames and MRI were taken. The images included coronal, digital andtraverse plane in SET1W1,T2W1.The orientation and position of each branch ofthe deltoid ligaments were defined, and its length, width and thickness weremeasured.2. The gross anatomy of the deltoid ligaments in the ten specimens were detectedwith caliper rule and recorded, including its length, width and thickness.3. Eight patients with deltoid ligaments rupture were examined by stressradiography, CT and MRI scan before and after operation. The diagnostic value ofthe above methods were analyzed and compared with the arthroscope of anklejoint.Results:1. The length, width and thickness of the deltoid ligaments achieved by caliper rulerand MRI has no significant difference.2. The anterial tibiotalar ligament, tibionavicular ligament and calcaneotibialeligament appeard low signal in MRI images. The anterial tibiotalar ligament werewell displayed at the section of anterial medial malleolus on the coronal plane andat tibiotalar joint section on the transvers plane, while the tibionavicular ligamentwere well detected at the section of anterial medial malleolus on the coronal planeand at trochlea tali section on the transvers plane. Calcaneotibiale ligament werewell showed at the section of ultimate distal of medial malleolus on the coronalplane and at the section of inferior to the ultimate distal of medial malleolus on the transvers plane. The signal of the posterior tibiotalar ligaments wereunevenness and bulky with fat shadow in it, It can be well recognized at thesection of middle part of the medial malleolus on the coronal plane and at the tipof the medial malleolous section on the transvers plane.3. The stress radiographic image is valuable in dicision of the degree of injury of thedeltoid ligaments, but it should be compared with unaffected side.If the talar tiltangel is larger than 10 degrees on the valgus image, the deltoid ligaments injuryshould be suspicious.The tendens and ligaments can be well displayed on the MRIimages, it shows significant advantage in the diagnosis of ankle ligaments injurythan the X-ray and CT.Conclusion:The MRI finding of the ankle detoid ligament has comparabile to the anatomicmeasurement, which displays different part of the ligament on special section. Theinjury of the ligaments or other potential injuries can be found by the MRI imaging.Stress radiography of the ankle is the economical and fundamental screening methodin deltoid ligament injury. CT can not provid more diagnostic information exceptbone fracture.