An Anatomical Study on the Characteristics of the Shape of the Foot and Talofibular and Calcaneofibular Ligaments in Relation to the Different Number of Bundles of the Anterior Talofibular Ligament and its Relevance.

This study aimed to investigate anatomical features by comparing and verifying the shape of the talus and calcaneofibular ligament (CFL) depending on the number of anterior talofibular ligament (ATFL) bundles. We also aimed to reveal the relationship between the ATFL and talofibular and CFL. We examined 118 feet from 59 cadaveric specimens and measured the ATFL and CFL, as well as the length, width and thickness of the talus and foot, by using digital calipers. We counted the number of ATFL bundles, calcaneofibular ligament, talus and foot. The ATFL was divided into two groups: one group with one bundle and one group with two bundles. We further examined the relationship between the shapes of the ATFL, CFL, talus and foot. The results were tested for differences in sex and showed that women had significantly wider (p<0.05) and longer (p<0.05) talus in the two-bundle group than in the one bundle group. The CFL was also significantly longer in the two-bundle group (p<0.05). A moderately significant correlation was found between the shapes of the ATFL and the talofibular and CFL. This study provided new anatomical findings that the ATFL attached to the high talus has two bundles. In addition, the ankle joint evaluation and rehabilitation was basic research that considered sex differences.