The functional anatomy of the human anterior talofibular ligament in relation to ankle sprains

Tsukasa Kumai, Y. Takakura, A. Rufai, S. Milz, M. Benjamin

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

The anterior talofibular ligament is the most commonly injured ligament in the ankle. Despite considerable interest in the clinical outcome of treatment protocols, we do not know whether the distinctive pattern of localization of the injuries relates to regional differences in the structure and molecular composition of the ligament. To address this issue, ligaments were examined by histology and immunohistochemistry. Differences in the structure of its two attachments (i.e. entheses) were evaluated with quantitative, morphometric techniques, and regional differences in the distribution of collagens, glycosaminoglycans and proteoglycans were determined qualitatively by immunolabelling. Morphometric analyses showed that bone density was less at the fibular attachment, but that enthesis fibrocartilage was more prominent. Immunohistochemistry revealed the presence of a fibrocartilage (containing type II collagen and aggrecan) at the site where the ligament wraps around the lateral talar articular cartilage in a plantarflexed and inverted foot: the fibrocartilage is regarded as an adaptation to resisting compression. We propose that avulsion fractures are less common at the talar end of the ligament because (1) bone density is greater here than at the fibular enthesis, and (2) stress is dissipated away from the talar enthesis by the 'wrap-around' fibrocartilaginous character of the ligament near the talar articular facet.

Original languageEnglish
Pages (from-to)457-465
Number of pages9
JournalJournal of Anatomy
Volume200
Issue number5
DOIs
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

animal anatomy
Ankle Injuries
collagen
ligaments
Ligaments
anatomy
bone
Anatomy
avulsion
Fibrocartilage
histology
compression
bone density
Bone Density
immunohistochemistry
Immunohistochemistry
Aggrecans
Collagen Type II
proteoglycans
glycosaminoglycans

Keywords

  • Attachment
  • Avulsion fracture
  • Collagen
  • Enthesis
  • Fibrocartilage
  • Proteoglycan

ASJC Scopus subject areas

  • Anatomy
  • Ecology, Evolution, Behavior and Systematics
  • Histology
  • Molecular Biology
  • Developmental Biology
  • Cell Biology

Cite this

The functional anatomy of the human anterior talofibular ligament in relation to ankle sprains. / Kumai, Tsukasa; Takakura, Y.; Rufai, A.; Milz, S.; Benjamin, M.

In: Journal of Anatomy, Vol. 200, No. 5, 2002, p. 457-465.

Research output: Contribution to journalArticle

Kumai, Tsukasa ; Takakura, Y. ; Rufai, A. ; Milz, S. ; Benjamin, M. / The functional anatomy of the human anterior talofibular ligament in relation to ankle sprains. In: Journal of Anatomy. 2002 ; Vol. 200, No. 5. pp. 457-465.
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