Tuesday, February 23, 2010

50 - Medial and Lateral Collateral Ligaments of Ankle





1. MEDIAL COLLATERAL LIGAMENT (OR DELTOID LIGAMENT) OF ANKLE :

*It consists of two sets of fibers, superficial and deep. Both parts have a common attachment above to the apex and margins of the medial malleolus. The lower attachment is indicated by the name of the fibers.

*Superficial fibers :
- The most anterior (tibionavicular) fibers pass forward to be inserted into the tuberosity of the navicular bone, and immediately behind this they blend with the medial margin of the plantar calcaneonavicular ligament (spring ligament).
- The middle (tibiocalcaneal) fibers descend almost perpendicularly to be inserted into the whole length of the sustentaculum tali of the calcaneum
- The posterior fibers (posterior tibiotalar) pass backward and laterally to be attached to the medial side of the talus, and its medial tubercle.

*Deep fibers :
- The deep fibers (anterior tibiotalar) are attached to the anterior part of medial surface of the talus.

*The deltoid ligament is crossed by the tendons of the tibialis posterior and Flexor digitorum longus.


2. LATERAL COLLATERAL LIGAMENT OF THE ANKLE :

*The lateral collateral ligament has 3 discrete bands or parts:
a. The anterior talofibular ligament - extends anteromedially from the anterior margin of the fibular malleolus to the neck of the talus.
b. The posterior talofibular ligament - extends almost horizontally from the lateral malleolar fossa to the lateral tubercle of the talus.
c. The calcaneofibular ligament - is a long cord which passes from a depression anterior to the apex of the fibular malleolus to a tubercle on the lateral calcaneal surface. It is crossed by the tendons of the peroneus longus and brevis.

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Read this question from the May 2009 AIIMS Paper :

1q: Deltoid ligament is attached to all except :
a. Medial malleolus
b. Medial cuneiform
c. Spring ligament
d. Sustentaculum tali


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