The ankle is a modified hinge joint between the tibial plafond, medial and lateral malleoli proximally and the talus distally.
The inferior tibiofibular and subtalar joints are also intimately related to ankle function.
The ankle joint capsule is reinforced by the anterior talofibular (ATFL), calcaneofibular (CFL) and posterior talofibular ligaments (PTFL) laterally, and by the deltoid ligament medially, of which the deep tibiotalar part is the most important for ankle stability.
There are also anterior (ATFL), interosseous and posterior ligaments of the inferior tibiofibular joint and a posterior transverse band, the posterior intermalleolar ligament.
The subtalar joint is stabilised by the lateral, interosseous and cervical talocalcaneal ligaments, and by the calcaneofibular and superficial deltoid ligaments and the inferior extensor retinaculum, which cross both ankle and subtalar joints.
Anterolateral ankle structures
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More superficial structures Notice how the calcaneofibular ligament lies in the floor of the peroneal tendon sheath. Tears of this ligament allow communication between the ankle and the sheath through which contrast or an arthroscope can pass |
More superficial again The superior peroneal retinaculum may be torn in lateral ligament injuries |
Medial ankle structures The superficial tibiotalar ligament (1 posterior) is intermediate between superficial and deep deltoid |
More superficial structures 1 Tibialis posterior 2 Flexor dgitorum longus 3 Flexor hallucis longus 4 Knot of Henry |
Images are courtesy of Interactive Foot and Ankle (Primal Pictures)