According to human anatomy, the ligaments in the ankle are grouped by two ligament complexes, namely the lateral collateral ligament and the medial collateral ligament.  The ankle lateral collateral ligament complex has been the focus of multiple studies, however, there are no specific descriptions of how this group of ligaments are connected.  Now, a study from researchers at the University of Barcelona identifies a previously unknown anatomic structure in the ankle, the lateral fibulotalocalcaneal ligament (LFTCL) complex shown to link these two ligaments.  The team states the new structure, the LFTCL , is classed as intra-articular and is connected to the inferior anterior talofibular ligament (ATFL) fascicle and the calcaneofibular ligament (CFL) to make up the lateral collateral ligament along with the superior fascicle of the ATFL. The opensource study is published in the journal Knee Surgery, Sports Traumatology, Arthroscopy.

Previous studies show injury to the lateral collateral ligament complex of the ankle is a common finding in ankle sprains, frequently leading to ankle instability. Moreover, many people who suffer from this injury complain about a lingering pain in the ankle correlated with a high risk of suffering another sprain, factors as yet unexplained by medicine.  The current study describes in detail the components of the lateral collateral ligament complex, which is made up of the ATFL and the CFL, and determines its anatomical relationships.

The current study dissects 32 ankle specimens with over dissection of the area just distal to the inferior ATFL fascicle avoided. The characteristics and measurements of the ATFL and CFL, as well as any connecting fibers between them, were recorded.  Results show the superior fascicle of the ATFL is a distinct anatomical structure, whereas the inferior ATFL fascicle and the CFL are connected by a newly identified structure named the LFTCL complex.

The lab states their findings would explain why many sprains cause pain after the patient follows the treatment the doctor suggests.  They go on to add that since the intra-articular LTFCL ligament does not heal by scar formation, the resultant instability of the joint produces pain so these patients are likely to suffer from another sprain and develop other injuries in the weakened ankle.

The team surmises they have identified a new structure within the ankle, the LFTCL complex, connecting the inferior ATFL fascicle and the CFL.  For the future, the researchers state this newly discovered complex may allow repair between the inferior ATFL fascicle and the CFL in recurrent sprains.

Source: Universitat de Barcelona

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