Posteroinferior tibiofibular ligament - A cadaveric study

Abstract

Background: Ankle injuries are one of the most common musculoskeletal disorder. The purpose of this study was to analyze and describe the detailed anatomical arrangement and relationship of posterior ligaments of the ankle, especially de posteroinferior tibiofibular ligament (PITFL) and intermalleolar ligament (IML). Controversy exists in the previous literature regarding their morphology and denomination, as well as the relation with ankle injuries including posterior soft tissue impingement syndrome.

Methods: Seventeen fresh-frozen cadaveric feet were used. The origins, insertions, ligament lengths, orientations with respect to relevant bony landmarks of the PITFL were evaluated.

Results: PITFL was present in all anatomical specimens. It was formed by two independent components, the superficial and deep fibers. Their dimensions vary widely between specimens. The IML was located between the deep PITFL and posterior talofibular ligament. The shape varied from a thin fibrous band to a thick cordlike structure. The IML was evident in 82.4% of the ankles. In 28.6% of the cases, the posterior intermalleolar ligament was split into two bundles in the fibular insertion. In 14 ankles, three slips were found.

Conclusion: Given the frequency of injury and increasing necessity for surgical intervention, a more comprehensive anatomic knowledge of the different ligaments is warranted, provide clinically pertinent quantitative data and improve the treatment of these lesions.

Keywords: Ankle injuries; Intermalleolar ligament; Posteroinferior tibiofibular ligament.