title: Anatomy of the inferior extensor retinaculum and its role in lateral ankle ligament reconstruction: a pictorial essay.
abstract: The inferior extensor retinaculum (IER) is an aponeurotic structure, which is in continuation with the anterior part of the sural fascia. The IER has often been used to augment the reconstruction of the lateral ankle ligaments, for instance in the Broström-Gould procedure, with good outcomes reported. However, its anatomy has not been described in detail and only a few studies are available on this structure. The presence of a non-constant oblique supero-lateral band appears to be important. This structure defines whether the augmentation of the lateral ankle ligaments reconstruction is performed using true IER or only the anterior part of the sural fascia. It is concluded that the use of this structure will have an impact on the resulting ankle stability.
authors.affiliation: Laboratory of Arthroscopic and Surgical Anatomy, Human and Embryologic Anatomy Unit, Department of Pathology and Experimental Therapeutics, School of Medicine, University of Barcelona, Barcelona, Spain. mikeldalmau@gmail.com.|Faculty of Health Sciences at Manresa, University of Vic - Central University of Catalonia, Manresa, Barcelona, Spain. mikeldalmau@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Dalmau-Pastor
authors.affiliation: Teikyo University Department of Orthopaedic Surgery, Tokyo, Japan.|Hospital for Special Surgery, New York, NY, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Yasui
authors.affiliation: Fortius Clinic, London, UK.|Imperial College, London, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Calder
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Göthenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Karlsson
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.|Academic Center of Evidence Based Sports Medicine (ACES), Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands.
authors.forename: G M M J
authors.initials: GM
authors.lastname: Kerkhoffs
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Kennedy
mesh_terms: D000843:Ankle Joint / Q000033:anatomy & histology* / Q000601:surgery; D005205:Fascia / Q000033:anatomy & histology; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000033:anatomy & histology / Q000601:surgery*; D008023:Ligaments, Articular / Q000033:anatomy & histology; D013710:Tendons / Q000033:anatomy & histology
keywords: Anatomy; Ankle ligaments; Ankle ligaments repair; Broström-Gould; Inferior extensor retinaculum; Pictorial essay