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Knee Surgery, Sports Traumatology, Arthroscopy

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01-07-2018 | Ankle

X-shaped inferior extensor retinaculum and its doubtful use in the Bröstrom–Gould procedure

Authors: M. Dalmau-Pastor, F. Malagelada, G. M. M. J. Kerkhoffs, M. C. Manzanares, J. Vega

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2018

Abstract

Purpose

The inferior extensor retinaculum (IER) is an aponeurotic structure located in the anterior aspect of the ankle. According to the literature, it can be used to reinforce a repair of the anterior talofibular ligament in ankle instability. Despite its usual description as an Y-shaped structure, it is still unclear which part of the retinaculum is used for this purpose, or if it is instead the crural fascia that is being used. The purpose of this study is to define the anatomical characteristics of the IER to better understand its role in the Broström–Gould procedure.

Methods

Twenty-one ankles were dissected. The morphology of the IER and its relationship with neighbouring structures were recorded.

Results

Seventeen (81%) of the IER in this study had an X-shaped morphology, with the presence of an additional oblique superolateral band. This band, by far the thinnest of the retinaculum, is supposed to be used to reinforce the repair of the anterior talofibular ligament. The intermediate dorsal cutaneous nerve (lateral branch of the superficial peroneal nerve) was found to cross the retinaculum in all cases.

Conclusions

The IER is most commonly seen as an X-shaped structure, but the fact that the oblique superolateral band is a thin band of tissue probably indicates that it may not add significant strength to ankle stability. Furthermore, the close relationship of the retinaculum with the superficial peroneal nerve is another factor to consider before deciding to perform a Broström–Gould procedure. These anatomical findings advise against the use of the Gould augmentation.

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Title: X-shaped inferior extensor retinaculum and its doubtful use in the Bröstrom–Gould procedure
Authors: M. Dalmau-Pastor
F. Malagelada
G. M. M. J. Kerkhoffs
M. C. Manzanares
J. Vega
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-017-4647-y

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Springer Medicine

X-shaped inferior extensor retinaculum and its doubtful use in the Bröstrom–Gould procedure

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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