title: Comparative analysis of inter- and intraligamentous distribution of sensory nerve endings in ankle ligaments: a cadaver study.
abstract: BACKGROUND
  The aim of this study was to analyze the inter-, intraligamentous, and side-related patterns of sensory nerve endings in ankle ligaments.
  
  
  METHODS
  A total of 140 ligaments from 10 cadaver feet were harvested. Lateral: calcaneofibular, anterior-, posterior talofibular; sinus tarsi: lateral- (IERL), intermediate-, medial-roots inferior extensor retinaculum, talocalcaneal oblique and canalis tarsi (CTL); medial: tibionavicular (TNL), tibiocalcaneal (TCL), superficial tibiotalar, anterior/posterior tibiotalar portions; syndesmosis: anterior tibiofibular. Following immunohistochemical staining, the innervation and vascularity was analyzed between ligaments of each anatomical complex, left/right feet, and within the 5 levels of each ligament.
  
  
  RESULTS
  Significantly more free nerve endings were seen in all ligaments as compared to Ruffini, Pacini, Golgi-like, and unclassifiable corpuscles (P ≤ .005). The IERL had significantly more free nerve endings and blood vessels than the CTL (P ≤ .001). No significant differences were seen in the side-related distribution, except for Ruffini endings in right TCL (P = .016) and unclassifiable corpuscles in left TNL (P = .008). The intraligamentous analysis in general revealed no significant differences in mechanoreceptor distribution.
  
  
  CONCLUSIONS
  The IERL at the entrance of the sinus tarsi contained more free nerve endings and blood vessels, as compared to the deeper situated CTL. Despite different biomechanical functions in the medial and lateral ligaments, the interligamentous distribution of sensory nerve endings was equal.
  
  
  CONCLUSIONS
  The intrinsic innervation patterns of the ankle ligaments provides an understanding of their innate healing capacities following injury as well as the proprioception properties in postoperative rehabilitation.
authors: University Hospital Carl Gustav Carus, 01307 Dresden, Germany. susanne.rein@web.de
authors: Susanne
authors: S
authors: Rein
authors: Uwe
authors: U
authors: Hanisch
authors: Hans
authors: H
authors: Zwipp
authors: Armin
authors: A
authors: Fieguth
authors: Sophie
authors: S
authors: Lwowski
authors: Elisabet
authors: E
authors: Hagert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000294:innervation* / Q000473:pathology; D002102:Cadaver; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000294:innervation*; D008297:Male; D008465:Mechanoreceptors / Q000473:pathology; D008875:Middle Aged; D011434:Proprioception / Q000502:physiology; D011984:Sensory Receptor Cells / Q000473:pathology*
keywords: ankle; immunohistochemistry; ligaments; proprioception; sensory nerve endings