Morphological and Morphometric Characterisation of Lateral Ankle Ligament Complex in Human Cadavers: A Descriptive Cross-sectional Study

Introduction: The lateral ankle ligaments are the most common to get involved in ankle sprains and problems related to ankle instability, and a precise knowledge of the morphological features of these ligaments would be highly beneficial for diagnosis and treatment. Aim: To describe the attachments, and mean dimensions of the lateral ankle ligament complex. Materials and Methods: A descriptive cross-sectional study was conducted in the Department of Anatomy, Government Medical College, Thiruvananthapuram, Kerala, India, from March 2022 to 2023. A total of 56 embalmed cadavers donated for teaching purposes were dissected to evaluate the lateral ankle ligaments. The three lateral ankle ligaments, namely Anterior Talofibular (ATFL), Calcaneofibular (CFL), and Posterior Talofibular (PTFL) were identified. Their positions with respect to external bony landmarks were defined. The morphology of the ligaments, their site of attachments, length, and width were documented. The stretching of the ligaments and their orientation with the longaxis of the fibula with dorsiflexion and plantarflexion of the foot was noted. The morphological observations were presented in percentages. Assuming the numeric measurements of the morphometric analysis to be normally distributed, the data were summarised in mean and standard deviation. Results: The ATFL was found to consist of two bands in 32 (57.14%) ankles and a single band in 24 (42.86%) ankles. The CFL was cord like in 38 (67.9%) ankles and was single banded in 18 (32.1%) ankles. The lateral talocalcaneal ligament was observed to reinforce CFL in four ankles. The mean length of ATFL, CFL and PTFL were 19.24±2.31 mm, 28.16±3.56 mm, 25.03±3.53 mm, respectively and the mean width were 8.21±1.52 mm, 5.25±1.10 mm, 7.56±1.25 mm, respectively. Conclusion: The detailed anatomical knowledge would be vital in diagnosis and arthroscopic reconstruction of the injured ankle ligaments In the era of minimally invasive surgeries, the study findings would be promising for clinical practice and research.