An anatomical study about the arthroscopic repair of the lateral ligament of the ankle

Background: The purpose of this anatomical study to was to determine the relationship of the structures involved in the arthroscopic repair of the anterior talofibular ligament. Methods: Dissection of fifteen lower leg cadaveric specimens was made and distances in the anterior direction from the reference-point at the lateral malleolus origin of the anterior talofibular ligament were measured, to the talar insertion of the ligament, to the superficial peroneal nerve at 60 degrees and 90 degrees in relation to the lateral malleolus axis in the sagittal plane, and to the inferior extensor retinaculum. Results: The mean +/- SD distance to superficial peroneal nerve from the reference-point was 25 +/- 6 (range 17-35) mm at 60 degrees, and 32 +/- 9 (range 24-48) mm at 90 degrees in relation to the lateral malleolus axis. The mean +/- SD distance to the inferior extensor retinaculum was 20 +/- 5 (range 14-29) mm. The mean +/- SD length of the anterior talofibular ligament was 21 +/- 4 (range 13-29) mm. Conclusions: The superficial peroneal nerve demonstrated the greatest variance in its anatomy. An accessory incision to include the inferior extensor retinaculum in the repair should not surpass the 22 mm distance from the lateral malleolus in the anterior direction, due to the risk of damaging the nerve. (C) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.