{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:37:36Z","timestamp":1789771056080,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The anterior talofibular ligament (ATFL) consists of two fascicles, with the intra\u2010articular superior fascicle and extra\u2010articular inferior fascicle connected to the calcaneofibular ligament (CFL) via the arciform fibres, forming the lateral fibulotalocalcaneal ligament (LFTCL) complex. Accurate identification of which fascicles have been injured is useful for determining the optimal treatment of patients with lateral ligament injuries. There is a lack of imaging studies demonstrating the distinctive anatomy of these important structures on magnetic resonance imaging (MRI). Hence, the aim of this pilot study is to investigate interobserver reliability in identifying the fascicles of the ATFL and LFTCL complex on routine two\u2010dimensional (2D) MRI scans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010centre review of 100 consecutive routine 2D MRI ankles performed in our institution for reasons other than ankle sprain. The ATFL fascicles and LFTCL complex were independently reviewed by three clinicians, and interobserver reliability was analysed using Fleiss kappa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 46 males, and the average age was 47.7 years. In terms of the interobserver reliability, there was a substantial level of agreement in determining the number of fascicles for the ATFL (<jats:italic>k<\/jats:italic>\u2009=\u20090.688, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, 95% confidence interval [CI]: 0.575\u20130.801) which was similar to the CFL (<jats:italic>k<\/jats:italic>\u2009=\u20090.747, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, 95% CI: 0.633\u20130.860) while the arciform fibres had a moderate level of agreement (<jats:italic>k<\/jats:italic>\u2009=\u20090.489, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, 95% CI: 0.377\u20130.603). There were 54 MRI scans with bifascicular ATFL, while the rest had a single inferior ATFL fascicle. The LFTCL complex was identified in 99 scans. No differences were noted in age, gender or MRI strength in the ability to visualize these structures on routine 2D MRI scans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Routine 2D MRI can reliably identify the fascicles of the ATFL and LFTCL complex with moderate to substantial levels of agreement. This can help clinicians enhance their diagnostic accuracy and refine treatment strategies without relying on complex or costly imaging techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12642","type":"journal-article","created":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T13:52:11Z","timestamp":1741528331000},"page":"1884-1891","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Routine 2D MRI identifies the anterior talofibular ligament fascicles and lateral fibulotalocalcaneal ligament complex with moderate to substantial interobserver reliability"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0309-8096","authenticated-orcid":false,"given":"Choon Chiet","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery National University Hospital  Singapore"},{"name":"Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Thomas Patrick Decourcy","family":"Hallinan","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene Tze Chun","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-698X","authenticated-orcid":false,"given":"Miki","family":"Dalmau\u2010Pastor","sequence":"additional","affiliation":[{"name":"Human Anatomy Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences University of Barcelona Barcelona Spain"},{"name":"MIFAS by GRECMIP (Minimally Invasive Foot and Ankle Society) Merignac France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Calder","sequence":"additional","affiliation":[{"name":"Fortius Clinic (FIFA Medical Centre of Excellence) London UK"},{"name":"Department of Bioengineering Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gino M. M. J.","family":"Kerkhoffs","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC, Location University of Amsterdam Amsterdam The Netherlands"},{"name":"Amsterdam Movement Sciences, Sports, Musculoskeletal Health Amsterdam The Netherlands"},{"name":"Academic Decenter for Evidence\u2010Based Sports Medicine (ACES) Amsterdam The Netherlands"},{"name":"Amsterdam Collaboration on Health &amp; Safety in Sports, International Olympic Committee (IOC), Research Center Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuliang","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2004.011676"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06496-w"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231172196"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05794-8"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12052"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079801901002"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07270-2"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2022.12.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07275-x"},{"issue":"48","key":"e_1_2_11_11_1","article-title":"Chronic lateral ankle ligament instability\u2014current evidence and recent management advances","volume":"28","author":"Hong CC","year":"2023","journal-title":"J Clin Orthop Trauma"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4043-z"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0838.2002.02104.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0153"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512474967"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2022.01.009"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-77856-8"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096733"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.11.018"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06089-z"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5188-8"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3454-y"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092223"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509350757"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.12642","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T10:23:00Z","timestamp":1760869380000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.12642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,3]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/ksa.12642"],"URL":"https:\/\/doi.org\/10.1002\/ksa.12642","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,3]]},"assertion":[{"value":"2025-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}