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Major change in morphology of the talofibular ligaments during fetal development and growth

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Abstract

Background and purpose

Ankle sprain is often attributed to damage of the anterior and posterior talofibular ligaments (ATFL, PTFL). We compared the morphology of these ligaments in fetuses of different gestational ages (GAs) with the horizontal configuration in adults.

Materials and methods

Histological sections of unilateral ankles were examined in 22 fetuses, 10 at GA of 9–12 weeks and 12 at GA of 26–39 weeks.

Results

At a GA of 9 to 10 weeks, the ATFL and PTFL consisted of horizontally running straight fibers. The initial ATFL appeared as a thickening of the capsule of the talocrural joint, although the initial PTFL was distant from this joint. Until a GA of 12 weeks, the talus and fibula were separated by an expanding joint cavity. Thus, the initial horizontal ligaments were “pulled” in a distal direction. The distal parts of the ligaments consisted of thin collagenous fibers that had an irregular array, whereas the short proximal parts had thick fibers and a horizontal array. In near-term fetuses, the ligaments contained no horizontal fibers. The ATFL had a wavy course around the thick synovial fold, and was exposed to the joint cavity along the entire course; the distal part was thinner than the proximal part. The PTFL was bulky and consisted of fibers with an irregular array. Therefore, the morphology in a near-term fetus was quite different from that in adults.

Conclusion

The horizontal and straight composite ankle fibers in adults apparently result from postnatal reconstruction, depending on mechanical demand.

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Data availability

All data used in this work are available for verification upon request.

Abbreviations

ATFL:

Anterior talofibular ligament

CFL:

Calcaneofibular ligament

CRL:

Crown-rump length

FBT:

Fibularis brevis tendon or muscle belly

GA:

Gestational age

FLT:

Fibularis longus tendon

PTFL:

Posterior talofibular ligament

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Funding

This study was supported in part by a Grant-in-Aid for Scientific Research (JSPS KAKENHI No. 16K08435; to Hiroshi Abe) from the Ministry of Education, Culture, Sports, Science and Technology in Japan.

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Authors and Affiliations

  1. Department of Anatomy, Jeonbuk National University Medical School, Geunji-ro 20, Deukjin-gu, Jeonju, 54907, Korea

    Ji Hyun Kim

  2. Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China

    Zhe-Wu Jin

  3. Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Isehara, Japan

    Shogo Hayashi

  4. Division of Internal Medicine, Cupid Clinic, Iwamizawa, Japan

    Gen Murakami

  5. Department of Anatomy and Embryology, School of Medicine, Complutense University, Madrid, Spain

    José Francisco Rodríguez-Vázquez

  6. Emeritus Professor of Akita University School of Medicine, Akita, Japan

    Hiroshi Abe

Authors
  1. Ji Hyun Kim
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  2. Zhe-Wu Jin
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  3. Shogo Hayashi
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  4. Gen Murakami
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  5. José Francisco Rodríguez-Vázquez
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  6. Hiroshi Abe
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Contributions

JHK: project development, data collection, data analysis, manuscript writing. SH: data collection, data analysis, manuscript editing. GM: project development, data collection, data analysis, manuscript writing. JFR-V: data collection, data analysis, manuscript editing. HA: project development, data analysis, manuscript editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ji Hyun Kim.

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Competing interests

The authors declare no competing interests.

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No conflict of interest is to be declared.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The use of materials for research was approved by the Ethics Committee of Complutense University (B08/374) and Akita University (No. 1428).

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Kim, J.H., Jin, ZW., Hayashi, S. et al. Major change in morphology of the talofibular ligaments during fetal development and growth. Surg Radiol Anat 44, 1121–1129 (2022). https://doi.org/10.1007/s00276-022-02987-8

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  • DOI: https://doi.org/10.1007/s00276-022-02987-8

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