The clinical anatomy of the ligament of Barkow at the proximal tibiofibular joint

Abstract

IntroductionMention of the ligament of Barkow at the proximal tibiofibular joint is rarely found in the literature and it is not represented
in most anatomical atlases. To our knowledge, quantitation of this structure has not been performed. As injury to the knee
region is so common, a comprehensive knowledge of this regional anatomy is important to the clinician and surgeon alike.

Materials and methodsForty lower limbs from embalmed cadavers underwent dissection of the proximal leg with special attention toward the presence
or absence of ligament of Barkow. When identified, measurements of this structure were made.

ResultsThe ligament of Barkow was identified in 95% of specimens. For right sides, the mean width was 1.5cm and the mean length
was 1.2cm. For left sides, the mean width of this ligament was 1.2cm and the mean length was 1.5cm. The mean thickness
of ligament of Barkow was 1.2mm (range 0.9–1.4mm). The upper edge of this ligament was on average 3cm inferior to the inferior
most aspect of the proximal tibiofibular joint. The lower edge of ligament of Barkow was a mean distance of 7mm from the
anterior tibial artery at its entrance into the anterior compartment of the leg. One ligament was found to be fully ossified;
thereby, creating a bony bar superior to the anterior tibial vessels.

ConclusionsOur hopes are these data will help further elucidate the ligament of Barkow. Imaging studies are now necessary to further
elucidate functional and pathological involvement of this structure.