Anatomy And MRI Observation Of Ankle’s Lateral Collateral Ligament And Its Clinical Application

Objective: To measure the anatomic morphology of the lateral collateral ankle ligamentin cadavers, and compare it with the data measured by magnetic resonanceimaging(MRI),in order to provide the basis for improving the clinical diagnosis of theligament injury. Retrospective to analyze of the clinical data of the lateral ligament aboutankle joint injury. The purpose of this stuy was to analysis the clinical efficacy inconservative treatment for providing some valuable clinical references.Methods:10lateral ankle joints of normal adult cadavers specimens were observedanatomically. The length, width and thickness of the ligaments were observed andmeasured both by the MRI of0.4T HITACHI APERTO and anatomy in naturalposition(about in plantar flexion20°), and the data was used the paired t test to statisticallyanalyzed. The study retrospectively analyzed the40cases of the lateral ligament aboutankle joint injury that was treated by conservative treatment with U-shaped plaster in theperiod from June2010to October2013in the fifth Affiliated Hospital (Zhuhai) of ZunyiMedical College. This research that involved27males and13females, the age was from17to50, with the average age33.5. And15cases on the left side, right side25cases.Cause of injury:22cases of fall sprain in the normal walking, and18cases of sprain inrunning.In the40cases,of which15cases of bone contusion,13cases with the peronealtendon injury,26cases with joint hydrops. The curative effect outcomes which wasexpressed by treatment ankle function were scored by the Liu standard, and the resultswere showed such as excellent,good,fair and poor. When we used the statistical analysis,the results were divided into two groups,one group included excellent and good(≥80points), the other included fair and poor(≤79points), were used as chi squaretest(bonferroni methods). There were the statistically significant which were showed by p<0.0167.Results: The collateral ligament of the ankle joint was constituted by the three ligamentsand also called fibular collateral ligament, Its mainly composition has three independentstructure:the front is talofibular ligaments, middle is talofibular ligament and poseteriortalofibular ligament is located in the posterolateral of ankle joint. Two cases of the ATFLwere different from that described in the literatures.Variable anterior talofibular ligamentwas of double strip distribution. One strip began from front edges of the external malleolus,went anterior medially, and ended at the neck of talus, another one was located below it.The CFL was outside organization who on the joint capsule,started from the front of thelateral malleolus tip and ended at outside of the calcaneus.The PTFL was starting atarticular capsule of posterolateral and ended at the talus’lateral tubercle. The MR can betterdisplay the ligaments of the anatomical morphology on natural position. The ATFL,CFLand PTFL were measured by MR, the average length respective were (14.190±0.595) mm,(23.46±1.578)mm and (19.37±1.360) mm,while the average width were (8.76±0.883) mm,(5.700±0.442)mm and(6.400±0.200)mm.The thickness were(1.840±0.190)mm,(2.110±0.296)mm and (2.570±0.200)mm respectively.And the anatomic length were(14.128±0.610)mm,(23.452±1.506)mm and (19.220±1.164)mm.The width were(8.782±0.916)mm,(5.704±0.453)mm and(6.400±0.174)mm,and the average thickness were(1.882±0.224)mm,(2.106±0.313)mm and (2.588±0.206) mm respectively.The data had no significant differences(P＞0.05)between the results of MR and anatomic.In40patients’ curative effect outcomesⅠdegrees injury were17excellent and good，fair and poor were1;Ⅱ degrees were10excell-ent and good，fair and poor were2; and then the former were3, but the latter were achieve-d to7in the Ⅲ degrees injury. There was not statistical difference between theⅠdegreesandⅡdegrees(P＞0.0167);The Ⅲ degrees had statistical difference between theⅠdegreesandⅡ degrees (P＜0.0167).Conclusion: All of measurements showed that have no statistical discrepancy betweenMR and anatomical.The supine natural position was the better MR examinational posture for the lateral ligament of ankle joint. The low field strengths MR can accurate observe themorphological structure of the lateral collateral ligament. With regard to the patients whoseligament were injuredⅠdegrees andⅡdegrees maybe restore to health by conservativetreatment, but others people who was recommended to accept the surgery treatment inⅢdegrees injury.