Physio-metabolic alterations in Labeo rohita (Hamilton, 1822) and native predator Chitala chitala (Hamilton, 1822) in presence of an invasive species Piractus brachypomus (G. Cuvier, 1818).

A 60 days study was conducted to evaluate the physiological response of indigenous species Labeo rohita (LR) and indigenous predator Chitala chitala (CC) in presence of an invasive species Piaractus brachypomus (PB). Two treatment groups as LR + PB (T1) and LR + PB + CC (T2) with individual control groups as T0LR, T0PB and T0CC were designed in triplicates. Fingerlings of LR, PB and CC were randomly distributed into 15 circular tanks with a stocking ratio of 1:1 and 1:1:0.3 in T1 and T2 group, respectively and 10 nos. each of LR, PB and CC in respective control groups. At first 15 min of the experiment, cortisol level was found significantly (P < 0.05) higher in all three experimental fishes in T1 and T2 groups. With the experimental duration, the level of stress hormone (cortisol), oxidative stress enzymes (superoxide dismutase, catalase, and glutathione peroxidase), tissue metabolic enzymes (lactate dehydrogenase and malate dehydrogenase), serum metabolic enzymes (transaminase enzymes) and blood glucose level were significantly (P < 0.05) increased in T1 and T2 groups for LR and CC whereas, no variation (P > 0.05) were observed for PB in both T1 and T2 groups. The total antioxidant capacity (TAC), liver glycogen, total protein, albumin and globulin were found to be significantly (P < 0.05) decreased in LR in the presence of PB and CC. The present study provides a preliminary insight into the biological interaction between native and invasive species and their physiological responses in the presence of native predator with higher trophic index. Thus, the results of the study suggest the superior traits of invasive P. brachypomus try to dominate the other two native species by negatively influencing the native fauna even with a higher trophic index (C. chitala).

Microplastic contamination in salt-cured fish and commercial sea salts: an emerging food safety threat in relation to UN Sustainable Development Goals (SDGs).

Microplastic (MP) contamination in seafood, particularly processed varieties like dried and salt-cured fish, poses a significant threat to human health. This study investigated MP levels in 22 salt-cured fish species and commercial sea salts along the Indian east coast. Results showed substantially higher MP concentrations compared to global averages, with fragments and fibres (< 250 µm) composing 70% of identified MPs, primarily PVC and PS polymers (> 55%). Station 2 exhibited high pollution levels, with salt-cured fish averaging 54.06 ± 14.48 MP items/g and salt containing 23.53 ± 4.2 MP items/g, indicating a high hazard risk index. A modest correlation was observed between MP abundance, morphotypes, polymer composition in the salt, and their impact on fish products. Given the critical link between food safety, security, and public health, further research is imperative to mitigate MP contamination, aligning with UN Sustainable Development Goals (Goal 2, Goal 3, Goal 14, and Goal 15) for enhanced food safety and security.

Assessment of microplastic contamination in the gastrointestinal tracts of indigenous fishes from north eastern hill regions of Bhogdoi, a tributary of River Brahmaputra, India.

Microplastic (MP) pollution in freshwater environments has drawn considerable attention over the decades due to the risk posed by MPs to the aquatic fauna and human health. In this study, the occurrence of MPs was assessed from the gastrointestinal tracts (GIT) of indigenous fishes from Bhogdoi River, a tributary of River Brahmaputra, northeast hill region, Assam, India. All the fish species (n = 180) analysed showed 100% occurrence of MPs sampled from three stations of River Bhogdoi. A total of 488 microplastic particles were recorded from GIT of fishes collected. The mean abundance of MPs was highest in Station-II (7.64 ± 2.77 numbers individual-1) with lowest in S-I (3.17 ± 0.99 numbers individual-1). The MP size of 100-500 µm, MP shape of fibre (43.33%) and fragments (35.33%), blue colour MPs (26-37%) and polymer type PA (23-30%) were most prevalent in fishes analysed from River Bhogdoi. The mean abundance of MPs was higher in herbivore fishes (8.52 ± 1.22 numbers individual-1) as compared to carnivorous and omnivorous fish species with highest abundance in Labeo rohita (12.11 ± 2.13 numbers individual-1). Fibre and fragments with size range of 100-500 µm were dominant among all the feeding habits. Blue and black colour MPs were abundant among herbivore and carnivore fishes. Fourier transform infrared spectroscopy results confirmed that polyamide and polypropylene were the most abundant MP polymer in the fishes analysed. The present study provides baseline information of MPs in River Bhogdoi, Assam, for its future monitoring and assessment of contaminants.

Extraction, optimization, and functional quality evaluation of carotenoproteins from shrimp processing side streams through enzymatic process.

The study aimed to develop an effective and eco-friendly enzymatic process to extract carotenoproteins from shrimp waste. The optimization of enzymatic hydrolysis conditions to maximize the degree of deproteinization (DDP) of carotenoprotein from shrimp head waste (SHW) and shrimp shell waste (SSW) was conducted separately using the Box-Behnken design of response surface methodology (RSM). To achieve a maximum DDP of 92.32% for SSW and 96.72% for SHW, the optimal hydrolysis conditions were determined as follows: temperature (SSW: 53.13 °C; SHW: 45.90 °C), pH (SSW: 7.13; SHW: 6.78), time (SSW: 90 min; SHW: 61.18 min), and enzyme/substrate ratio (SSW: 2 g/100 g; SHW: 1.18 g/100 g). The carotenoprotein effluent obtained was subjected to spray drying and subsequently assessed for color, nutritional, and functional characteristics. The carotenoprotein from shrimp shell (CpSS) contained a higher essential amino acid score than carotenoprotein from shrimp head (CpSH). CpSS had a higher whiteness index of 82.05, while CpSH had 64.04. Both CpSS and CpSH showed good functional properties viz solubility, emulsion, and foaming properties. The maximum solubility of CpSH and CpSS was determined to be 92.94% and 96.48% at pH 10.0, respectively. The highest emulsion capacity (CpSH: 81.33%, CpSS: 70.13%) and stability (CpSH: 57.06%, CpSS: 63.05%) were observed at 3% carotenoprotein concentration. Similarly, the highest values of foaming capacity (CpSH: 27.66%, CpSS: 105.5%) and stability (CpSH: 23.83%, CpSS: 105.33%) were also found at the same 3% carotenoprotein concentration. In conclusion, the carotenoproteins obtained from shrimp waste showed favorable attributes in terms of color, amino acid composition, and functional properties. These findings strongly suggest the potential applicability of CpSS and CpSH as valuable resources in various domains. CpSS, with its higher whiteness index, greater amino acid content, and superior functional characteristics, may find suitability as functional ingredients in human food products. Conversely, CpSH could be considered for incorporation into animal feed formulations.

Comparative efficiency of native and non-native starter culture in the production of bio-silage using composite waste from fish and vegetables.

The efficiency of native and non-native starter cultures in the production of bio-silage using composite waste from fish and vegetables was studied. An ensilage experiment was conducted in a natural way (without starter culture) of composite waste (fish to vegetable at 80 to 20%) to isolate the native fermentative microflora. An Enterococcus faecalis strain isolated from the natural ensilage of composite waste showed higher efficiency over other commercial LAB strains generally used for ensilation. A total of 60 isolates were screened and characterized biochemically from ensilaged composite waste. Among them, 12 proteolytic and lipolytic positive isolates were identified as Enterococcus faecalis, based on a BLAST search of the 16S rRNA gene sequences. Subsequently, composite bio-silage was prepared by inoculating starter cultures with three (3) treatments T1 (native-Enterococcus faecalis), T2 (non-native-Lactobacillus acidophilus), T3 (a mixture of E. faecalis and L. acidophilus) and compared with control (composite bio-silage without starter culture). The highest non-protein nitrogen (0.78 ± 0.01 mg of N /100 g) and degree of hydrolysis (70.00 ± 0.06% of protein/100 g) was seen in the T3 sample, and the lowest (0.67 ± 0.02 mg of N/100 g and 50.40 ± 0.04% of protein/100 g) was seen in the control. At the end of ensilation, the pH fell (5.95-3.88) in conjunction with the formation of lactic acid (0.23-2.05 g of lactic acid/100 g), and the lactic acid bacteria count nearly doubled (log 5.60-10.60). The lipid peroxidation products PV (0.11-0.41 milli equivalent of oxygen/kg of fat) and TBARs (1.64-6.95 mg of malonaldehyde/kg of silage) were changed within a reasonable range in the following pattern Control > T2 > T3 > T1, which led to oxidatively stable products. The findings revealed that native starter culture E. faecalis, which can be employed as a single or in combination with non-native L. acidophilus, performed better in the bio-ensilation process. Additionally, the finished composite bio-silage can be used as a novel, protein-carbohydrate rich feed component to help manage wastes from both sectors.

Outcomes of Combined Posterior Tibial Tendon Tendoscopy and Medializing Calcaneal Osteotomy for Stage IA Progressive Collapsing Foot Deformity.

BACKGROUND: Posterior tibial tendon (PTT) tendoscopy and medializing calcaneal osteotomy (MCO) are among the available techniques for patients presenting with symptomatic flexible hindfoot valgus (stage IA) progressive collapsing foot deformity (PCFD). The aim of this study was to determine clinical and radiographic outcomes of combined PTT tendoscopy and MCO for patients presenting with symptomatic stage IA PCFD. METHODS: A retrospective cohort study was performed in order to determine clinical and radiographic outcomes of 30 combined PTT tendoscopies and MCO on 27 patients presenting with symptomatic stage IA PCFD, with a minimum follow-up of 24 months. Patient satisfaction was assessed at last available follow-up as very satisfied, satisfied, and unsatisfied. Clinical assessment was performed evaluating preoperative and last available follow-up visual analog scale for pain (VAS-P), Foot and Ankle Outcome Score (FAOS), and the 36-Item Short Form Health Survey (SF-36). Magnetic resonance imaging (MRI) was performed preoperatively on all patients. Standard weightbearing anteroposterior, lateral, and long axial view radiographs of the foot and ankle were taken preoperatively, immediate postoperatively, at 6 weeks, 3 months, 6 months, 1 year postoperatively, and last follow-up evaluation available for each patient. RESULTS: The mean follow-up was 38.6 (range, 26-62) months. We registered 27 very satisfied, 1 satisfied, and 2 unsatisfied patients. There was statistically significant improvement on all clinical scores (VAS-P, FAOS and SF-36), as well as on lateral talo-first metatarsal and hindfoot alignment angles. We found low-grade PTT tears in 5 patients (16.67%) in whom preoperative MRI documented PTT tenosynovitis alone. CONCLUSION: We found that combined PTT tendoscopy and MCO provide significant clinical and radiographic improvement for patients presenting with symptomatic stage IAB PCFD. PTT tendoscopy should be considered in the treatment of all surgically addressed flexible valgus feet as it detects tendon tears which are frequently missed on an MRI. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Anatomy of the Ankle and Subtalar Joint Ligaments: What We Do Not Know About It?

Understanding of the ankle and subtalar joint ligaments is essential to recognize and manage foot and ankle disorders. The stability of both joints relies on the integrity of its ligaments. The ankle joint is stabilized by the lateral and medial ligamentous complexes while the subtalar joint is stabilized by its extrinsic and intrinsic ligaments. Most injuries to these ligaments are linked with ankle sprains. Inversion or eversion mechanics affect the ligamentous complexes. A profound knowledge of the ligament's anatomy allows orthopedic surgeons to further understand anatomic or nonanatomic reconstructions.

Radiological and Anatomical Evaluation of First Metatarsal Pronation in Hallux Valgus Deformity: A Comparison Between Three Different Methods.

A frontal plane metatarsal rotational (pronation) has been documented in a high percentage of hallux valgus patients. Pathoanatomical concepts leading to pronation are still debated. Nevertheless, there is no consensus on how to measure this component of the deformity. The aim of the present study was to compare three commonly used radiographic methods to measure the frontal plane deformity in hallux valgus deformity, such as 1. Round sign of the lateral edge of the first metatarsal head on anterior-posterior radiograph, 2. Non-weightbearing CT-scan and 3. Bernard's axial projection of the first metatarsal head. Afterwards, feet were dissected, and a direct measurement of the pronation was done. Our data showed that alpha angle measurements made through the Bernard's axial projection were closer with those obtained during the dissection compared to those made through the CT-scan. The main finding of our study is that osteoarthritic changes at the metatarso-sesamoid joint play an important role in severe hallux valgus cases. The proposed radiographic methods allow surgeons to verify whether rotation can be corrected during Hallux Valgus procedures and to determine which procedure may be the best for each patient.

Complications after total ankle arthroplasty- A systematic review.

BACKGROUND: Total ankle arthroplasty was developed as an alternative option to ankle arthrodesis in patients with end-stage ankle osteoarthritis. Multiple trials have assessed the outcomes of ankle arthroplasty, but complication risk or relative effectiveness is not systematized in literature. AIM: Review complications of new designs of total ankle arthroplasty and the relationship between their severity and failure rates. METHODS: We reviewed complications and revision rates of prospective studies of primary total ankle arthroplasty that included more than 50 patients and with minimum 2 years follow-up. RESULTS: We included 22 studies (4412 ankles, median age of 61.9 years) with an adjusted mean follow-up time of 66.6 ± 40.9 months. The adjusted mean complication rate was 23.7 % (2.4-52 %), mostly high-grade complications (35.6 %). We found a statistically significant positive correlation between high- and medium-grade complications and revision rates. CONCLUSION: Patient selection is crucial to successfully treat end-stage ankle osteoarthritis. Further multicenter clinical trials with consistent reporting of complications are warranted.

Anatomy of the tibial nerve in relation to the tarsal tunnel: A cadaveric study.

BACKGROUND: Tarsal tunnel syndrome (TTS) is typically caused by an anatomical variant or mechanical compression of the tibial nerve (TN) with variable success after surgical treatment. METHOD: 40 lower-leg specimens were obtained. Dissections were appropriately conducted. Extremities were prepared under formaldehyde solution. The tibial nerve and branches were dissected for measurements and various characteristics. RESULTS: The flexor retinaculum had a denser consistency in 22.5% of the cases and the average length was 51.9 mm. The flexor retinaculum as an independent structure was absent and 77.2% of cases as an undistinguished extension of the crural fascia. The lateral plantar nerve (LPN) and abductor digiti minimi (ADM) nerve shared same origin in 80% of cases, 34.5% bifurcated proximal to the DM (Dellon-McKinnon malleolar-calcaneal line) line 31.2% distally and 34.3% at the same level. CONCLUSION: Understanding the tibial nerve anatomy will allow us to adapt our surgical technique to improve the treatment of this recurrent pathology.

Abundance and characteristics of microplastics in gastrointestinal tracts and gills of croaker fish (Johnius dussumieri) from off Mumbai coastal waters of India.

The present study was conducted to establish the intensity of microplastic pollution in demersal fish species, Johnius dussumieri, from the north eastern coastal waters of the Arabian sea. MP recovered were analysed for size, morphology, colour, and polymer type. The study results indicated that the GI tract and gills of individual fishes had 6.6 ± 1.7 and 6.2 ± 1.7 items, respectively. The microplastics having a size of <100 µm consisting of beads were found to be most predominant. Black and blue were the most present colours of microplastic in the tissues. Among the different studied months, a higher number of MP incidence was observed in the post monsoon period. There is no significant correlation observed between the microplastic numbers in gills and guts tissue. The present study shows that there is a potential risk of microplastic bioaccumulation in the fish body and subsequent risk to the consumers and organisms sharing the food chain.

Osteosynthesis or primary arthrodesis for displaced intra-articular calcaneus fractures Sanders type IV - A systematic review.

BACKGROUND: Displaced intra-articular calcaneus fractures (DIACF) Sanders type IV represent a challenge in its management and questions remain about the best treatment option available. This study aimed to compare the outcomes of primary subtalar arthrodesis (PSTA) and osteosynthesis in these fractures. METHODS: Studies concerning DIACF Sanders type IV, from 2005 to 2020 were systematically reviewed. Only studies evaluating functional outcomes with American Orthopaedic Foot & Ankle Society ankle-hindfoot (AOFAS) score were admitted allowing for results comparison. RESULTS: In total, 9 studies met the inclusion criteria. These reported on the results of 142 patients, from which 41 submitted to PSTA and 101 to osteosynthesis, with an average follow-up period over 2 years. We found a significant moderate negative correlation between the reported AOFAS score and the Coleman Methodology Score obtained. Late subtalar arthrodesis was 13.63% of the total osteosynthesis performed. CONCLUSIONS: Clinical outcomes after PSTA and osteosynthesis, for the treatment of Sanders type IV fractures, do not seem very different, yet careful data interpretation is crucial. Additional powered randomized controlled trials are necessary to assess which surgical strategy is better.

Current Concepts on Subtalar Instability.

Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conservative or surgical treatment and result in chronic ankle instability. Understanding the accurate anatomy and biomechanics of the subtalar joint, their interplay, and the contributions of the different subtalar soft tissue structures is fundamental to correctly diagnose and manage subtalar instability. An accurate diagnosis is crucial to correctly identify those patients with instability who may require conservative or surgical treatment. Many different nonsurgical and surgical approaches have been proposed to manage combined or isolated subtalar instability, and the clinician should be aware of available treatment options to make an informed decision. In this current concepts narrative review, we provide a comprehensive overview of the current knowledge on the anatomy, biomechanics, clinical and imaging diagnosis, nonsurgical and surgical treatment options, and outcomes after subtalar instability treatment.

Outcomes of Posterior Arthroscopic Subtalar Arthrodesis for Medial Facet Talocalcaneal Coalition.

BACKGROUND: Medial facet talocalcaneal coalition can be a painful condition. This study aimed to determine clinical and radiographic outcomes of posterior arthroscopic subtalar arthrodesis (PASTA) for adult patients presenting with symptomatic medial facet talocalcaneal coalition and normal hindfoot alignment, with a minimal follow-up of 18 months. METHODS: Between June 2017 and July 2019, this procedure was performed on 8 feet (8 patients; mean age, 55 [42-70] years; mean BMI, 29.8 [24.4-45.0] kg/m2). Clinical assessment was performed using Visual Analog Scale for Pain (VAS-P), Foot and Ankle Outcome Score (FAOS) and the 36-Item Short-Form Health Survey (SF-36). Patient satisfaction was assessed at the last available follow-up as "very satisfied", "satisfied" or "unsatisfied". Radiographic analysis was performed using plain radiography, computed tomography (CT) scan and magnetic resonance imaging (MRI). The primary outcome was to determine both clinical and radiographic outcomes. RESULTS: The mean follow-up was 25.1 (18.2-34.2) months. The authors found statistically significant improvement on all clinical scores (VASP-P, FAOS and SF-36). They registered 6 "very satisfied" patients, 2 "satisfied" patients and no "unsatisfied" patient. Fusion of the subtalar joint was observed in all patients by 12 weeks and in 5 of them as soon as 8 weeks postoperatively (mean, 9.5 [8-12] weeks). There were no cases of delayed fusion or nonunion of the subtalar joint, superficial or deep infection, neurovascular damage, thromboembolic event, screw breakage, need for hardware removal or revision surgery. CONCLUSION: This study found that PASTA is a safe and reliable technique for adult patients presenting with symptomatic medial facet talocalcaneal coalition and normal hindfoot alignment, demonstrating and maintaining clinical improvement at an average follow-up of 2 years. LEVEL OF EVIDENCE: Level IV, case series.

Microplastics in shrimps: a study from the trawling grounds of north eastern part of Arabian Sea.

Accumulation of microplastics (MPs) in marine organisms poses an imminent environmental threat and health risk due to the possibility of trophic transfer of accumulated MPs in ecologically important food chains. In this context, a field-level study was conducted on the fishing grounds of the north eastern part of the Arabian Sea through experimental fishing, and the gastrointestinal tracts (GT) of three different species of shrimps (n=180) were examined for the incidence of microplastics. The results showed that all shrimp caught from the fishing grounds had significant levels of MPs in the gastrointestinal tracts. A total number of 1220 microplastic items were recorded from the pooled samples, with an average of 6.78 ± 2.80 items per individual. The gastrointestinal tract showed an average number of 70.32 ± 34.67 MPs per gram of the gut material. The MPs with the size range of 100-250 µm were the most abundant form found in the shrimp species analyzed. Among the colored MP particles, black color was the most dominant (30.16%) form of MP. Fibers, fragments, pellets, beads, and films were the common morphotypes; however, fibers showed an occurrence of 39.40%, 47.39%, and 41.89% in the GTs of Metapenaeus monoceros, Parapeneopsis stylifera, and Penaeus indicus, respectively. In the present study, six types of plastic polymers were identified from the GTs of the studied samples. The findings confirm the presence of microplastics in the natural habitats of shrimps beyond the coast and indicate that shrimps caught from these coastal fishing grounds contain MPs in their gut. The findings underline the immediate scientific intervention for the microplastic reduction in the marine environment.

Complications on Percutaneous Hallux Valgus Surgery: A Systematic Review.

Lately there has been a growing interest in the use of percutaneous surgery for the correction of hallux valgus (HV). The purpose of the present study was to systematically review the published data about this topic and establish the efficacy and safety, stressing the complication rates found on this percutaneous technique. A systematic review of the literature available in PubMed was performed. The radiological and clinical outcomes were evaluated as well as complication rates. A total of 16 studies were included and 1157 procedures reported for percutaneous HV on 1246 patients. The mean angle correction of HV deformity improved postoperatively. Reported complications vary among the studies. The highest complication rate was joint stiffness in 18.47% of cases, followed by HV recurrence and shortening of M1, both in 15.2%, material intolerance in 10.1%, osteoarthritic changes in 9.1%, infection in 7.6%, and transfer metatarsalgia in 5.4%. There is a lack of randomized control trials and insufficient comparative case control studies to assess whether one technique is more effective than another or if the percutaneous surgery is recommended rather than open surgery with respect to complications.

Posteroinferior tibiofibular ligament - A cadaveric study.

BACKGROUND: Ankle injuries are one of the most common musculoskeletal disorder. The purpose of this study was to analyze and describe the detailed anatomical arrangement and relationship of posterior ligaments of the ankle, especially de posteroinferior tibiofibular ligament (PITFL) and intermalleolar ligament (IML). Controversy exists in the previous literature regarding their morphology and denomination, as well as the relation with ankle injuries including posterior soft tissue impingement syndrome. METHODS: Seventeen fresh-frozen cadaveric feet were used. The origins, insertions, ligament lengths, orientations with respect to relevant bony landmarks of the PITFL were evaluated. RESULTS: PITFL was present in all anatomical specimens. It was formed by two independent components, the superficial and deep fibers. Their dimensions vary widely between specimens. The IML was located between the deep PITFL and posterior talofibular ligament. The shape varied from a thin fibrous band to a thick cordlike structure. The IML was evident in 82.4% of the ankles. In 28.6% of the cases, the posterior intermalleolar ligament was split into two bundles in the fibular insertion. In 14 ankles, three slips were found. CONCLUSION: Given the frequency of injury and increasing necessity for surgical intervention, a more comprehensive anatomic knowledge of the different ligaments is warranted, provide clinically pertinent quantitative data and improve the treatment of these lesions.

The vascularization of the peroneal tendons: An anatomic study.

BACKGROUND: Arterial vascularization is intimately related to the peroneal tendon ruptures. Our purpose is to describe the vascular anatomy of peroneal tendons and assess differences in the vascularization patterns between peroneus brevis tendon (PBT) and peroneus longus tendon (PLT). METHODS: Anatomical study of 22 cadaveric lower extremities. We exposed tendons' vascularization by injecting latex. To systematize the vascular description, we considered four anatomical regions in the PBT and six in the PLT. RESULTS: Vascularization was supplied by the peroneal, anterior tibial and lateral plantar arteries and from the deep plantar arch through the vincula connecting the tendons. No avascular areas were found in the PLT. 22.7% of specimens had avascular areas in the PBT. Two visual vascularization patterns were found (arcuate and weblike). Increasing age and a web-like vascularization were associated with a lower number of blood vessels at the tendons' post malleolus area. CONCLUSION: Peroneal tendons are well vascularized throughout their course, running through a common vincula, with vascularization provided by various arteries. Avascular areas were observed in the PBT, but none at the PLT.

The calcaneofibular ligament has distinct anatomic morphological variants: an anatomical cadaveric study.

PURPOSE: The purpose of this study was to investigate if the calcaneofibular ligament (CFL) presents morphologic variants and measure the morphometrics of the ligament and its footprints METHODS: An anatomical study of 47 fresh-frozen below-the-knee ankle specimens was performed. Lateral ankle structures were dissected to expose the CFL. Overdissection was avoided to not modify the native morphology. The morphology (number and orientation of CFL bundles) and measurements of CFL insertions were recorded with ankle secured in neutral position. RESULTS: Four distinct morphological-oriented shapes of the CFL were observed. These included single bundle, Y-shape double bundle, V-shape double bundle, and associated with the lateral talocalcaneal ligament. The most frequent CFL morphology observed was the single bundle and the Y-shape double bundle, present in 21 (44.7%) and 13 (27.7%) ankles. The V-shape double bundle and the CFL double bundle associated with the lateral talocalcaneal ligaments were less common, appearing only in eight (17.0%) and five (10.6%) ankles. The CFL length was higher in single bundle and Y-shaped double bundle CFL variants, about 30 mm each. Footprint morphometrics were heterogenous amongst the different CFL variants. CONCLUSION: The CFL presents four distinct morphological-oriented shapes. The double bundle, V-shaped and Y-shaped CFL variants are uncommon and poorly reported in the literature. Their relation to the lateral talocalcaneal ligament and the inferior fascicle of the anterior talofibular ligament requires further research. The CFL morphology provides detailed knowledge of CFL anatomy that can improve diagnostic procedures. Furthermore, this information can fine-tune graft selection and sizing and allow a more precise anatomic placement during surgical reconstruction.