Anatomy of ligaments of the prenatal ankle joint and its clinical relevance
Authors:
Tomáš Pešl 1; Ondřej Naňka 2; Petr Havránek 1
Authors‘ workplace:
Dept. of Pediatric and Trauma Surgery, 3rd Faculty of Medicine, Charles University in Prague and Thomayer Teaching Hospital, Prague
1; Klinika dětské chirurgie a traumatologie 3. LF UK a FTN
1; Charles University in Prague, 1st Faculty of Medicine, Institute of Anatomy
2; Univerzita Karlova v Praze, 1. lékařská fakulta, Anatomický ústav
2
Published in:
Úraz chir. 18., 2010, č.3
Overview
Introduction:
The aim of our study was to examine the anatomy of the ligamentous apparatus of the ankle joint in a growing skeleton. We have focused especially on the relation between the distal tibial and fibular physes and insertion of the ligaments.
Material and method:
An autopsy of six ankle joints in stillborns of ages between 32 to 35 weeks of gestation was performed. In none of them nor orthopaedic nor neurological lesions were apparent.
Results:
All ligaments in all six dissected stillborn joints had already been fully developed prenatally and corresponded to the adult ligamentous apparatus. All but one ligaments were attached at the distal tibial and fibular epiphysis distally to the physis. The only exception was the interosseous tibiofibular ligament – a strengthened distal part of the interosseous membrane, which was stretched between the distal tibial and fibular metaphyses just above the physis.
Discussion:
Until now, all studies regarding the development of the growing ankle joint in the literature have dealt with the successive ossification only and the ligamentous apparatus has been concerned just marginally. The relation between the skeleton, ligaments and physis has not been mentioned at all. We have demonstrated that the ligamentous anatomy of the growing and adult ankle joint is identical. The relation between the insertion of the ligament and the distal tibial or fibular physis has its clinical relevance in understanding the etiopathogenesis and treatment of the physeal and/or epiphyseal injuries to this region.
Key words:
ankle joint, child, growth plate, physeal injuries, anatomy, ligaments of the ankle joint.
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Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2010 Issue 3
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