This document describes the ligaments of the ankle joint. It notes that the ankle joint is stabilized by a capsule attached above and below the tibia, fibula, and talus. The main ligaments discussed are the anterior/posterior tibiofibular ligaments, crural interosseous ligament, medial collateral (deltoid) ligament, and lateral collateral ligament complex. The medial collateral ligament controls eversion while the lateral collateral ligament controls inversion and prevents subluxation. Injuries to the ligaments, particularly the lateral ligaments, are common ankle injuries.
2. CAPSULE OF ANKLE
JOINT
Attachment:
Above the border of the articular surfaces of
the tibia and malleoli and below to the talus
around its upper articular surface.
And attaches to the hollow on the medial
surface of the lateral malleoli.
It is fairly thin and especially weak
anteriorlly and posteriorlly.
Laterally the capsule is thickened.
5. Anterior and posterior inferior
tibiofibular ligament:
attachment:
ANTERIOR:
It attches to the anterior tubercle of
the distal tibia to anterior surface of
the distal fibula at the lateral
malleolus.
POSTERIOR:
It attches to the posterior edge of
the lateral malleolus to posterior tibial
tubercle.
FUNCTIONS:
One of the primary stabilisers limits
excessive external rotation of foot on
the leg. And distal fibular motion of
the tibia.
6. Crural interosseous
tibiofibular ligament:
attachment:
It is thickened portion of the distal
interosseous membrane.
It is attches to the fibular notch (Incisura
tibialis) to talocrural joint of the fibula.
FUNCTIONS:
One of the primary stabilisers buffer to
neutralise forces during weight bearing as
it transfers some of the axial compressive
load to the fibula.
Spring action- allowing for minor
separation between the distal tibia and
fibula during dorsiflexion.
Allowing slight wedging of the talus in
the mortise.
7. Biomechanical functions :
Commonly,
It provide strong stabilization and dynamic support to the ankle
mortise.
Maintain the integrity between the distal tibia and fibula,
Resist forces (axial, rotational and translational) that attempt to
seperate the 2 bones.
8.
9. 1) Medial collateral ligament
Also known as deltoid ligament.
Its triangular in shape and consists of a superficial and
deep layer which connect the talus to the medial
malleolus.
It reinforces the joint capsule medially.
Stabilise’s the ankle joint during eversion of the foot.
it prevents sublexation of the ankle joint.
10. MEDIAL COLLATERAL
LIGAMENT (or) DELTOID
LIGAMENT:
attachment :
1)ANTERIOR TIBIOTALAR
LIGAMENT:
Medial malleolus to the head of talus.
2)POSTERIOR TIBIO TALAR
LIGAMENT:
Medial malleolus to the talus posteriorly.
3)TIBIO NAVICULAR LIGAMENT:
Medial malleolus to the Dorsomedial
aspect of the navicular.
4)TIBIO CALCANEAN LIGAMENT:
It is very thin. Attaches to the medial
malleolus to the sustentaculum tali.
11. Biomechanical functions:
1) ANTERIOR TIBIOTALAR LIGAMENT:
Reinforces the ankle joint and control plantar flexion & eversion.
2) POSTERIOR TIBIOTALAR LIGAMENT:
It control dorsiflexion.
3) TIBIO NAVICULAR LIGAMENT:
Reinforces the ankle joint.
4) Tibio calcanean ligament:
Reinforces the ankle joint.
MCL is also provide stability of the mortise and talus.
It provide stability of the ankle or medial joint stability.
It also provide support for the subtalar joint.
14. Anterior talo fibular ligament
:
attcahment:
It attaches to the Lateral malleolus to
the neck of talus.
It is most commonly injured ligament
of the ankle or LCL.
Position- Anteriomedially.
FUNCTIONS:
Restrain anterior displacement of the
talus in respect to the fibula and tibia.
Resists inversion in plantar flexion.
This ligament is stressed when the
ankle is moved into greater degrees of
plantar flexion, medial rotation, and
inversion.Rupture of the anterior
talofibular ligament often results in
anterolateral rotary instability of the
ankle.
15. Posterior talofibular
ligament:
attachment:
It attaches to the malleolar fossa
of fibula.
It is rarely injured ligament of LCL
(because bony stability protects
ligament).
Position- horizontally medially.
It is thick and fairly strong band.
FUNCTIONS:
Forms the back wall of the
recipient socket for the talus’
trochlea.
Resists posterior displacement of
talus.
16. Calcaneo fibular ligament:
Attachment:
It attaches to the Tip of lateral malleolus to the lateral surfece of calcaneus.
Position- Posterioinferiorlly.
Functions :
Aids talofibular stability during dorsiflexion.
Restrain inversion of the calcaneus with respect to the fibula.
It also prevent Talar tilt into inversion.
The inferior band of the superior peroneal retinaculum , which lies close and
parallel to the calcaneofibular ligament, appears to reinforce that ligament. Because
the ankle collateral ligaments and retinacula also contribute to stability of the subtalar
joint.
17. Commonly,
MCL controls the eversion and/or pronation of foot.
LCL controls the inversion and/or supination of foot. And prevents
subluxation of the ankle joint.
In addition to the medial collateral and lateral collateral ligaments, portions of
the extensor and peroneal retinacula of the ankle are also credited with
contributing to stability at the ankle joint.
In general, the components of the lateral collateral ligament are weaker and
more susceptible to injury than are those of the medial collateral ligament.
18. APPLIED ANATOMY
1. Medial collateral ligament of foot -injury
2. Lateral collateral ligament of foot -injury
3. Medial and/or lateral malleoli injury
4. High ankle sprain or syndesmotic ankle sprain.
