Anterior Talofibular Ligament

Kumai T, Takakura Y, Rufai A et al (2002) The functional anatomy of the human anterior talofibular ligament in relation to ankle sprains. J Anat 200 457-465... 

Recently, three-dimensional computed tomography (3DCT) with volume rendering has been used for diagnosing several soft tissues, such as the muscles, hand, and wrist tendons, or anterior talofibular ligament (ATFL) of the ankle [1-3]. 

Nakasa T, Fukuhara K, Adachi N, Ochi M (2006) Evaluatimi of anterior talofibular ligament lesion using 3-dimensional computed tomography. J Cranput Assist Tomogr 30 543—547... 

The anterior talofibular ligament goes from the anterior margin of the lateral malleolus forward and medially to attach to the lateral aspect of the neck and the lateral articular facet of the talus. The posterior talofibular ligament runs from the lower part of the lateral malleolus to the lateral tubercle of the posterior process of the talus. The calcaneofibular ligament runs from the apex of the lateral malleolus downward and backward to the tubercle on the lateral surface of the calcaneus (Fig. 95-3). 

Specific clinical tests in ankle injuries include the anterior drawer and the talar tilt. The anterior drawer maneuver is applied by immobilizing the patient s distal tibia with one hand while applying pressure against the back of the foot with the other (Fig. f6.12a). In complete tears of the anterior and posterior ligaments, and especially of the anterior talofibular ligament, the talus is shifted anteriorly... 

Fig. 16.12 a,b. Clinical tests, a The anterior drawer test (arrows) is carried out by grasping the patient s distal tibia with one hand while pulling the calcaneus anteriorly with the other. When the anterior talofibular ligament is torn, the talus shifts anteriorly, b Thompson s test is carried out by squeezing the calf. If the Achilles tendon is intact, this maneuver produces plantar flexion (arrow). Absence of plantar flexion in this test indicates a rupture of the Achilles tendon... 

Synovitis in the anterior subtalar joint can also be assessed with US by placing the transducer just below and anterior to the anterior talofibular ligament to examine the groove between calcaneus and talus synovitis of the posterior subtalar joint is best evaluated by scanning its posterior recess that is located just caudal to the posterior recess of the ankle joint (Fig. 16.88). 

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