[Ankle and Foot_02] Two fascicles of the anterior talofibular ligament (ATFL)

 

The anterior talofibular ligament (ATFL) is composed of the superior (S-ATFL) and inferior fascicle (I-ATFL).

 

Both fascicles have a contiguous footprint on the anterior distal fibula border, however, their distal insertion on the talus is located apart from each other.

 

The superior fascicle of the ATFL is a distinct anatomical structure, whereas the inferior ATFL fascicle and the CFL share some features being both isometric ligaments, having a common fibular insertion, being connected by arciform fibers, and forming a functional and anatomical entity, that has been named the lateral fibulotalocalcaneal ligament (LFTCL) complex.

 

The ATFL superior fascicle inserts at the body–neck junction of the talus and it is an intraarticular structure of the ankle, whereas the ATFL inferior fascicle inserts more plantarly in the talar body and it is an extra-articular structure.

 

The superior ATFL fascicle is an intra-articular ligament, that will most probably not be able to heal after a rupture, and a microinstability of the ankle is developed.

 

After an inversion ankle injury, the superior fascicle of the ATFL is the first ligament to be torn, and ankle initial instability or microinstability is the result.

 

When symptomatic, patients complain of instability with a negative anterior drawer test, associated with a history of repetitive ankle sprains, anterolateral ankle pain, or a combination of them.

 

However, if the force of injury continues, after the ATFL—superior fascicle of the ATFL is torn, the LFTCL complex—inferior fascicle of the ATFL and the CFL—is injured next, and the patient develops mechanical ankle instability.

 

Patients will usually complain of the ankle giving way and will have a positive anterior drawer test and/ or a positive talar tilt test

 

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#AnkleMRI, #FootMRI, 

#MSKMRI_ANKLE

#ligament, #Anatomy, #ATFL, #LFTCL, #ankleligament,

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