Collateral Ligament Case Study

The lateral and medial collateral ligaments

The collateral ligaments, found in the ankle, consist of three main bands on the lateral and nedial aspect. There are a number of bands that accompany the collateral ligaments. The lateral collateral ligaments are comprised of the anterior talofibular ligament (ATL), the calcaneofibular ligament (CFL) and the posterior talofibular ligament. The supplementary bands that are related with the lateral compound are the lateral talocalcaneal ligament (LTCL), and the posterior intermalleolar ligament. The medial collateral ligament, also referred to as the deltoid ligament, is divided into a superficial, and deep compartment. The main bands found medially consist of the tibiospring ligament (TSL), the tibionavicular

The anterior talofibular ligaments main function is to minimize the anterior dislocation of the talus and plantar flexion of the ankle.

The ligament is associated with the capsule of the ankle joint, and it is comprised of two distinct bands. These bands are divided vascular branches originating from the perforating peroneal artery and it forms a junction with lateral malleolar artery. The anterior talofibular ligament is derived from the anterior border of the lateral malleolus. It was observed that the general width of the anterior talofibular ligament does not show much variation and the variations that were noted posed no impact to the function of the ligament. At the anterior border of the lateral malleolus the anterior talofibular ligament courses anteriomedially, and it attaches to the talar body directly onto the area where the lateral malleolus is located. The ligament essentially lies parallel to the ankle joint when it is relaxed however during dorsiflexion the ligament rises, and during plantar flexion it declines. The superior band is a slacked while the inferior band is tensed during dorsiflexion. In plantar flexion, the inferior band is slacked whilst the superior band is tensed. During plantar flexion the ligament is subject to stress and therefore it is susceptible to damage. Brostrom L

It runs level in a horizontal line and attaches to the posterolateral aspect of the talus bone. In plantar flexion and in the neutral lower leg position, the ligament is slackened, whereas in dorsiflexion, the ligament is taut. The ligament has multiple facets therefore it does not attach to a single restricted area. The fibers of the posterior talofibular ligament attach onto the posterior aspect of the talus, on the lateral talar process or onto the os trigonum if it is existent in the individual. Several of these fibers may be part of the formation of the tunnel for the flexor hallucis longus tendon. In addition, a band of strands merge with the posterior intermalleolar ligament [29]. The posterior intermalleolar tendon has been the focus of current studies as a result of its contribution in the posterior soft tissue impingement disorder at the ankle joint[17, 27]. Its high frequency in incidence in radiological, and anatomical studies contrast extensively, extending from 19% up to 100% [24, 27, 30]. Springer ( ) noted that in cadaveric dissection the intermalleolar ligament was found consistently. In the late investigation of Oh et al. [27] on the structure of the posterior intermalleolar ligament and its relationship with MR pictures, the posterior intermalleolar ligament was visible in 81.8% of the examples (63 of 77 examples). In MRI