Talonavicular ligament: prevalence of injury in ankle sprains, histological analysis and hypothesis of its biomechanical function

• Published in: British journal of radiology 2017-03, Vol.90 (1071), p.20160816-20160816
• Main Authors: De Dea, Miriam, L Loizou, Constantinos, Allen, Georgina M, Wilson, David J, Athanasou, Nick, Uchihara, Yoshinobu, Cooke, Paul, Cosker, Thomas
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Ankle Injuries - diagnostic imaging; Ankle Injuries - pathology; Ankle Joint - diagnostic imaging; Ankle Joint - pathology; Ankle Joint - physiopathology; Biomechanical Phenomena; Cadaver; Female; Histological Techniques; Humans; Lateral Ligament, Ankle - diagnostic imaging; Lateral Ligament, Ankle - pathology; Lateral Ligament, Ankle - physiopathology; Male; Middle Aged; MSK/Soft tissues; Prospective Studies; Tomography, X-Ray Computed; Ultrasonography; Young Adult
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20160816

To assess the prevalence of injury of the talonavicular ligament (TNL) in ankle sprains, its anatomy and the stability of the talonavicular joint (TNJ) before and after dividing the TNL in a cadaver. During a prospective study of 100 patients to assess the outcome of ankle injuries, we noted high incidence of TNL injuries; we will discuss here the TNL findings. Each patient had undergone ultrasound and cone beam CT examination of the ankle. Six TNLs were dissected off fresh-frozen cadaveric feet for histological analysis. In further six cadaveric feet, the stability of the TNJ was assessed by mechanical stress before and after division of the TNL; movement at the joint was assessed by measuring the distance between the talus and navicular bone [talonavicular distance (TD)] using ultrasound. The TD was measured on ten randomly selected ultrasound images by three independent observers and repeated twice by a single observer to determine the inter- and intraobserver reliability. 21% of the patients had an injury to the TNL. Histological examination demonstrated a dense connective tissue composed of bundles of collagen in parallel arrangement along the ligament length. The interobserver and intraobserver reliability of the TD showed almost perfect agreement. Displacement at the TNJ after stress with the TNL intact measured 0.18 ± 0.08 cm and 0.29 ± 0.07 cm (p