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Morphologie : Bulletin de L'Association... Dec 2022Though injuries to the distal tibiofibular (DTF) syndesmosis are commonly encountered in orthopedic and trauma settings, its anatomical structures have been poorly... (Meta-Analysis)
Meta-Analysis Review
Though injuries to the distal tibiofibular (DTF) syndesmosis are commonly encountered in orthopedic and trauma settings, its anatomical structures have been poorly researched. The commonly overlooked DTF ligament injuries are known to cause chronic ankle pain, instability and post-traumatic osteoarthritis. Quantitative and morphological evidence synthesis has not been yet conducted. A meta-analysis was conducted to collect data from morphological studies to document more accurate details on the prevalence, size, and insertion sites of its components. The Checklist for Anatomical Reviews and Meta-Analyses (CARMA) was followed. Ten studies met the inclusion criteria with a total of 265 investigated ankles. The analysis demonstrated that the anterior and posterior tibiofibular ligaments along with the interosseous ligament were present in 100% of joints. The inferior transverse tibiofibular and the distal fascicle of the anterior tibiofibular ligament were the least prevalent with frequencies of 96% and 86.5%, respectively. The inferior transverse ligament was recorded as the longest ligament. The widest ligament was found to be the interosseous tibiofibular ligament at its fibular attachment. The thickest of the ligamentous components was the posterior tibiofibular ligament. While more cadaveric research is warranted, these results would help directing future biomechanical investigations and planning new research to further aid in diagnostic and therapeutic approaches to the injuries of the distal tibiofibular syndesmosis.
Topics: Humans; Ankle Joint; Joint Instability; Ligaments, Articular; Fibula; Cadaver
PubMed: 34801386
DOI: 10.1016/j.morpho.2021.10.004 -
Clinics in Podiatric Medicine and... Oct 2019Flexible fixation has been described and utilized in various aspects of foot and ankle surgery over the past several decades. In regards to ankle surgery, flexible... (Review)
Review
Flexible fixation has been described and utilized in various aspects of foot and ankle surgery over the past several decades. In regards to ankle surgery, flexible fixation devices have been used for stabilization of the ankle syndesmosis and augmentation of lateral collateral ankle ligament repair. In the foot, flexible fixation devices have been incorporated into hallux valgus or varus correction, Lisfranc injury repair, and more recently spring ligament repair augmentation. This article reviews the various applications for flexible fixation in foot and ankle surgery, as well as evidence-based literature on surgical applications and clinical outcomes.
Topics: Ankle Fractures; Ankle Injuries; Foot Injuries; Humans; Internal Fixators; Ligaments, Articular; Sutures
PubMed: 31466567
DOI: 10.1016/j.cpm.2019.06.003 -
The Journal of Hand Surgery Nov 2022Most current surgical techniques for scapholunate interosseous ligament injuries address the dorsal component only. Previously, volar capsulodesis has been described... (Review)
Review
Most current surgical techniques for scapholunate interosseous ligament injuries address the dorsal component only. Previously, volar capsulodesis has been described either as an open approach or an "all-inside" technique. In this article, we report an alternative arthroscopic technique to address volar scapholunate interosseous ligament injuries. Arthroscopic-assisted volar scapholunate capsulodesis may be considered in the treatment algorithm for volar scapholunate interosseous ligament injuries.
Topics: Humans; Ligaments, Articular; Wrist Joint; Lunate Bone; Scaphoid Bone; Joint Instability
PubMed: 35965143
DOI: 10.1016/j.jhsa.2022.05.018 -
Clinics in Sports Medicine Oct 2021Ankle sprain is the most common injury in athletic populations. Ligament and tendon pathologies of the ankle are common, ranging from traumatic injuries to degeneration... (Review)
Review
Ankle sprain is the most common injury in athletic populations. Ligament and tendon pathologies of the ankle are common, ranging from traumatic injuries to degeneration leading to chronic pain and acquired foot deformities. MRI is the imaging modality of choice to evaluate tendon and ligament pathology of the ankle, specifically derangements of tendons and ligaments. 3-T MRI offers improved imaging characteristics relative to 1.5-T MRI, allowing for better delineation of anatomic detail and pathology. This article provides a review of the anatomy and common pathologies of the ankle ligaments and tendons using high-resolution 3-T MRI.
Topics: Ankle; Humans; Ligaments, Articular; Magnetic Resonance Imaging; Tendon Injuries; Tendons
PubMed: 34509208
DOI: 10.1016/j.csm.2021.05.009 -
Clinics in Sports Medicine Jan 2022Through this article, the authors aim to summarize the techniques performed on both first time and recurrent skeletally immature patients experiencing patellar... (Review)
Review
Through this article, the authors aim to summarize the techniques performed on both first time and recurrent skeletally immature patients experiencing patellar dislocation. This article focuses on several key points, such as the importance of medial patellofemoral ligament femoral insertions being distal to the growth plate and performing extensive lateral release and quadricep tendon lengthening in cases of obligatory dislocation. Although acknowledging the procedures discussed cannot be considered for all patients, as individuals with open growth plates may require additional operative time, in many cases these techniques yield high rates of success.
Topics: Humans; Knee Joint; Ligaments, Articular; Patellar Dislocation; Patellofemoral Joint; Tendons
PubMed: 34782079
DOI: 10.1016/j.csm.2021.07.004 -
Foot and Ankle Clinics Jun 2023Ankle microinstability results from the superior fascicle of anterior talofibular ligament (ATFL) injury and is a potential cause of chronic pain and disability after an... (Review)
Review
Ankle microinstability results from the superior fascicle of anterior talofibular ligament (ATFL) injury and is a potential cause of chronic pain and disability after an ankle sprain. Ankle microinstability is usually asymptomatic. When symptoms appear, patients describe a subjective ankle instability feeling, recurrent symptomatic ankle sprains, anterolateral pain, or a combination of them. A subtle anterior drawer test can usually be observed, with no talar tilt. Ankle microinstability should be initially treated conservatively. If this fails, and because superior fascicle of ATFL is an intra-articular ligament, an arthroscopic procedure is recommended to address.
Topics: Humans; Ankle; Ankle Joint; Joint Instability; Lateral Ligament, Ankle; Ligaments, Articular; Sprains and Strains
PubMed: 37137627
DOI: 10.1016/j.fcl.2023.01.008 -
Clinics in Sports Medicine Oct 2020Despite the fact that ankle fractures are common injuries, not all patients obtain satisfactory results. Historically, the deltoid ligament injury and intra-articular... (Review)
Review
Despite the fact that ankle fractures are common injuries, not all patients obtain satisfactory results. Historically, the deltoid ligament injury and intra-articular pathology have not often been treated at the time of fracture stabilization. Recent literature has suggested that repair of the deltoid ligament may lead to better stability of the ankle mortise. Additionally, the use of arthroscopy in conjunction with fracture fixation may allow for better identification and treatment of intra-articular lesions and improve detection and reduction of subtle instability.
Topics: Ankle Fractures; Ankle Injuries; Arthroscopy; Fracture Fixation, Internal; Humans; Ligaments, Articular; Treatment Outcome
PubMed: 32892964
DOI: 10.1016/j.csm.2020.06.003 -
Folia Morphologica 2023The perforating cutaneous nerve/perforating nerve of the sacrotuberous ligament is rarely observed. It usually arises from the posterior division of the sacral plexus or...
BACKGROUND
The perforating cutaneous nerve/perforating nerve of the sacrotuberous ligament is rarely observed. It usually arises from the posterior division of the sacral plexus or the pudendal nerve and perforates the sacrotuberous ligament. The anatomy of this nerve and its variants is poorly described in the literature, but there are data indicating its role in pudendal neuralgia.
MATERIALS AND METHODS
Herein, we present an anatomical study of six formalin-fixed cadavers with descriptions of the topography of spinal nerves S2-S4, the pudendal bundle, the perforating cutaneous nerve and the sacrotuberous ligament.
RESULTS
We found three perforating cutaneous nerves and described each of them in detail, with measurements of length and width, and point of perforation of the sacrotuberous ligament.
CONCLUSIONS
We distinguished three types of perforating cutaneous nerve on the basis of our findings and previous publications; two of the three types were observed in our study.
Topics: Humans; Pudendal Nerve; Lumbosacral Plexus; Pelvis; Ligaments, Articular; Cadaver
PubMed: 35099048
DOI: 10.5603/FM.a2022.0001 -
Arthroscopy : the Journal of... Nov 2019The medial patellofemoral ligament is the primary static restraint to lateral patellar translation. It is injured in 96% to 100% of patellar dislocations that affect... (Review)
Review
The medial patellofemoral ligament is the primary static restraint to lateral patellar translation. It is injured in 96% to 100% of patellar dislocations that affect approximately 6 to 29 of 100,000 patients and is more common in patients younger than 20 years of age. Risk factors for patellar dislocation include patella alta, trochlear dysplasia, genu valgus, increased Q angle, and hyperlaxity. The treatment for patellar instability depends on the clinical and radiographic findings and can be nonoperative for first-time dislocations (bracing, proximal strengthening, and progressive return to sport) or operative for recurrent dislocations. It is critical for medial patellofemoral ligament reconstruction to reproduce the anatomy and isometry of the native ligament. Graft choice and methods of fixation are less critical to achieve successful outcomes. Studies have reported successful outcomes and improved Kujala scores, with recurrent instability ranging from 1% to 5%. Careful surgical technique can avoid complications, including fracture, graft failure, loss of range of motion, persistent anterior knee pain, medial instability, and recurrent instability. The role of the medial quadriceps tendon femoral ligament also should be considered more in future research.
Topics: Humans; Ligaments, Articular; Patellar Dislocation; Patellofemoral Joint; Range of Motion, Articular; Plastic Surgery Procedures; Tendons
PubMed: 31699243
DOI: 10.1016/j.arthro.2019.09.008 -
Clinics in Sports Medicine Oct 2023Acromioclavicular joint separations are common shoulder injuries that require prompt recognition, diagnosis, and treatment. Deciding on a treatment algorithm relies on a... (Review)
Review
Acromioclavicular joint separations are common shoulder injuries that require prompt recognition, diagnosis, and treatment. Deciding on a treatment algorithm relies on a detailed knowledge of anatomy and a thorough understanding of the specific functional demands of the patient in question. When a repair or reconstruction is indicated, arthroscopic assistance can be a helpful tool to ensure a safe, anatomic reconstruction that minimizes morbidity and maximizes the potential return to high-level function.
Topics: Humans; Acromioclavicular Joint; Ligaments, Articular; Algorithms; Shoulder Injuries
PubMed: 37716724
DOI: 10.1016/j.csm.2023.05.004