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Wheeless' Textbook of Orthopaedics
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Anterior Talofibular Ligament



- See:
      - Anterior Drawer Test:

- Anatomy:
      - it connects anterior fibula to neck of talus;
      - ligament is thickening of ankle capsule that extends short distance from anterior
            edge of distal part of fibula to talar neck, anterior to its lateral articular facet;
      - ligament is 20 mm long, 10 mm wide, and 2 mm thick;
      - w/ the foot plantigrade, its fibers are oriented 75 deg to the floor;
      - w/ plantar flexion, its fibers approach vertical orientation;
      - anterior and posterior talofibular ligaments blend in with the joint capsule (unlike
            the calcaneal fibular ligament);
            - thus capsular tears accompany tears of the 2 talofibular ligaments;
      - distance from tip of fibula to center of fibular attachment of anterior talofibular ligament is 10 millimeters;

- Discussion:
      - weakest of the lateral ligaments;
      - prevents anterior subluxation of talus when ankle is in plantar flexion;
      - orientation of ant talofibular lig depends on position of ankle Joint.
            - in plantar flexion, it is parallel to long axis of foot, whereas in dorsiflexion, it is aligned w/ tibial
                  & fibular shafts;
            - strain in ATFL is minimum in dorsiflexion & neutral, & it increased as ankle is moved
                  progressively thru plantar flexion;

- Exam:
      - it is difficult to be certain which lig is being evaluated w/ each of clinical tests;
      - commonly used tests for eval of lateral ligament laxity of ankle are
          anterior drawer & talar tilt tests.
      - inversion (supination) test
      - w/ ankle in plantarflexion: evaluates anterior talofibular ligament;
      - in neutral / sl. dorisflexion: evaluates calcaneofibular ligament;



The contribution of the anterior talofibular ligament to ankle laxity.

Biomechanical evaluation of the anterior drawer test: the contribution of the lateral ankle ligaments.

Instability of the hindfoot after lesion of the lateral ankle ligaments: investigations of
    the anterior drawer and adduction maneuvers in autopsy specimens.




Original Text by Clifford R. Wheeless, III, MD.