Anatomy of lateral ankle ligaments and their relationship to bony landmarks

This study was designed to determine and describe precise anatomy of the lateral ankle ligaments and their relationship to adjacent osseous structures. This study was performed on 42 legs of 22 adult human embalmed cadavers. The lateral ankle ligaments were carefully dissected using a 2.5x surgical loupe. Mean values for the length, width and angle of the individual lateral ankle ligaments were measured. The precise location of insertion points and course of each ligament was observed and noted with ankle placed in neutral position. The anterior talofibular and calcaneofibular ligaments were coated with radio-opaque material. Radiographs were then taken in the anteroposterior, mortise and lateral projections. The anterior talofibular ligament (ATFL) was a flat, quadrilateral ligament and it made mean angle of 25 degrees (range 5 degrees-45 degrees) with horizontal plane, and a mean angle of 47 degrees (range 45 degrees-56 degrees) with sagittal plane. The posterior talofibular ligament was oriented in a nearly horizontal plane. Calcaneofibular ligament (CFL) was a flat oval ligament. It made a mean angle of 40 degrees (range 30 degrees-58 degrees) with horizontal plane, and mean angle of 51 degrees (range 32 degrees-60 degrees) with sagittal plane. The angle between CFL and ATFL was approximately 132 degrees (range 118 degrees-145 degrees). These data provides important information for diagnosing injury and reconstructing lateral ankle ligaments.