MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

Abstract

Neelu Prasad1, Mahesh Prasad2

BACKGROUND
The ankle joint is one of the most frequently injured joint. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. The talocrural joint is a major weight bearing joint of the body. The weight of the body is transmitted from the tibia and fibula to the talus which distributes the weight anteriorly and posteriorly within the foot. One sixth of the static load of the leg is carried by the fibula at the tibiofibular joint. These require a high degree of stability which is determined by the passive and dynamic factors. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture.
Conventionally, X-ray techniques have been used to diagnose ligament injuries.
Magnetic resonance (MR) imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities.
The anatomy of the deltoid ligament is very poorly understood. The ligament in case of tear or injury has to be repaired which is impossible to do so if a proper morphometric knowledge is not known. So a sincere effort has been put in the study to find the morphometry of the deltoid ligament.
METHODS
? One hundred specimens were dissected. In this, fifty belonged to the right and fifty belonged to the left side.
? The study was done in the Department of Anatomy, Nalanda Medical College, Patna.
? The study was done from June 2015 to April 2016.
? The morphometry was seen and the comparisons were done.
? The dissection was done to expose the deltoid ligament. The anterior, middle and posterior length was taken. Then, the superior, middle and inferior width was taken. Then, the thickness was measured.
? Then, the presence or absence of the deep part was noted.
RESULTS
Irrespective of the side and sex to which the ligaments belong, the mean value of the length of the deltoid ligaments in the anterior, middle and posterior parts are 24.40 mm, 21.53 mm and 17.20 mm. The widths in the superior, middle and inferior parts are 19.94 mm, 22.59 mm and 27.45 mm. The thickness mean measurement is 6.94 mm.
Deep Part was found in 100% of cases.
The superficial part trapezoid in shape wide anteriorly and narrow posteriorly, also is narrow superiorly where it arises and broad inferiorly where it gets inserted.
CONCLUSION
The ligaments of the talocrural joint are one of the most difficult ligaments to study. A sincere effort has been put in this study to find the morphometry of ligaments of ankle joint. The same has been studied and reported successfully to help the surgeons to understand and help the needful in a better way.

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