I have been very curious about the double fascicle anatomy of the ATFL since I read this article by Dr. Vega
I know an anatomist lectured on this topic at the ISS….was really excellent, but I can’t seem to find who that was anymore…..not sure if we can still access those on demand.
I wonder if anyone is reporting, or trying to make sense of differential injury to the superior and inferior fascicles of the ATFL.
Case in point:
This is actually the opposite of what I think I generally see.
The superior fascicle (white arrow) is intact.
The red arrow points to the inferior fascicle….with all that periligamentous edema that you can trace continuously to the CFL) between the peroneals and calcaneus…..because, according to this article, they are connected by arciform fibers (fancy word!) forming an LFTCL complex….so they are injured in concert with one another.
I don’t know if that means that we see CFL injury in association with all/most inferior fascicle injury—-but we certainly see Isolated superior fascicle tear sparing the CFL frequently.
Here the arrow points to the contiguously injured CFL
Superior fascicle is minding its own business.
All that edema inferiorly along the course of the inferior fascicle and CFL.
Are you reporting this?
Does anyone care?
Hilary
