The Ankle Retinacula: Morphological Evidence of the Proprioceptive Role of the Fascial System

NewsBot · Mar 4, 2010

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The Ankle Retinacula: Morphological Evidence of the Proprioceptive Role of the Fascial System.
Stecco C, Macchi V, Porzionato A, Morra A, Parenti A, Stecco A, Delmas V, De Caro R.
Cells Tissues Organs. 2010 Feb 27. [Epub ahead of print]

Objectives: To evaluate the anatomical characteristics of the ankle retinacula and their relationship with the fasciae and muscles in healthy subjects and in patients with ankle sprain outcomes.

Background: The role of the retinacula in proprioception has begun to emerge, but without clear anatomical bases or descriptions of their possible damage in patients with ankle sprain outcomes.

Methods: Dissection, histological and immunohistochemical analysis of 27 legs. An in vivo radiological study by MRI was also performed on 7 healthy volunteers, 17 patients with outcomes of ankle sprain, and 3 amputated legs.

Results: The retinacula are thickenings of the deep fascia presenting bone or muscular connections. They are formed of 2-3 layers of parallel collagen fibre bundles, densely packaged with a little loose connective tissue, without elastic fibres but many nervous fibres and corpuscles. By MRI, the retinacula appeared as low-signal-intensity bands with a mean thickness of 1 mm. In patients with outcomes of ankle sprain, MR findings were abnormal retinacula thickness, signal intensity, and full-thickness gap.

Discussion: The retinacula are not static structures for joint stabilisation, like the ligaments, but a specialisation of the fascia for local spatial proprioception of the movements of foot and ankle. Their anatomical variations and accessory bundles may be viewed as morphological evidence of the integrative role of the fascial system in peripheral control of articular motility.
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NewsBot · Oct 14, 2017

Mid-foot retinaculum: an unrecognized entity
Swathi, Geetha Gangadaran Nellithala, and Sunita Arvind Athavale
Anat Cell Biol. 2017 Sep;50(3):171-174

Retinacula are thickenings of deep fascia in the region of joints that hold down the tendons preventing them from bowing out of position. In the region of ankle, number of such retinacula have been described. Retinacula like superior and inferior extensor retinacula have been described which hold down the tendons of leg muscles passing to the foot beneath them. As the extensor tendons of the leg have more distal attachment to the toes, the present study was conducted to ascertain the presence of any additional retinaculum in the mid-foot region, which would tie down the tendons for their effective action at the distal joints. The aim was also to determine the attachments of the retinaculum, if present as well as the structures passing beneath them. Fifty cadaveric feet were dissected carefully for this purpose. Presence of an additional extensor retinaculum distal to the inferior band of inferior extensor retinaculum in the mid-foot region was found in 22 feet. Besides the extensor tendons, medial terminal branch of deep peroneal nerve and dorsalis pedis artery was found to pass beneath the retinaculum. A partial or complete mid-foot retinaculum existed in the mid-foot region covering the tarsometatarsal joints in about half of study population. Functionally, this retinaculum may prevent bowstringing of the extensor tendons, clinically it may predispose to entrapment of deep peroneal nerve mimicking anterior tarsal tunnel syndrome.
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