Ankle Joint

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Anatomy

Articulating Surfaces

Trochlea of Talus
Malleolar Mortis formed by Tibia & Fibula
Lateral & Medial Malleolus

Joint Capsule

The articular capsule surrounds the joints, and is attached, above, to the borders of the articular surfaces of the tibia and malleoli; and below, to the talus around its upper articular surface. The joint capsule anteriorly is a broad, thin, fibrous layer, posteriorly the fibres are thin and run mainly transversly blending with the transverse ligamanet and laterally the capsule it is thickened, and attaches to the hollow on the medial surface of the lateral malleolus. The synovial membrane lining the fibrous layer extends superiorly between teh tibia and fibula as far as the interosseous tibiofibular ligamanet. 

Ligaments

Lateral Ligaments of Ankle

Reinforce Joint Laterally through three ligaments. These ligaments stabilize the ankle, and serve as a guide to direct ankle motion by attaching the lateral malleolus to the bones below the ankle joint. .They are responsible for resistance against inversion and internal rotation stress.

Ligament	Description	Proximal Attachment	Distal Attachment	Role
Anterior Talofibular Ligament  (ATFL)	Flat Weak Band that extends Anteriomedially.  Most commonly damaged ligament of the ankle.	Lateral Malleolus	Neck of Talus	Restrain anterior displacement of the talus in respect to the fibula and tibia. Resists Inversion in planterflexion.
Posterior Talofibular Ligament  (PTFL)	Thick, fairly strong band that runs horizontally medially. This ligament is under greater strain in full dorsiflexion of the ankle.  Rarely injured except in severe ankle sprains because bony stability protects the ligaments when the ankle is in dorsiflexion.	Malleolar Fossa of Fibula	Lateral Tubercle of Talus	Forms the back wall of the recipient socket for the talus' trochlea. Resists posterior displacement of the talus.
Calcaneofibular Ligament  (CFL)	Round cord that passes posterioinferiorly	Tip of Lateral Malleolus	Lateral Surface of Calcaneus	Aids Talofibular stability during Dorsiflexion. Restrain inversion of the calcaneus with respect to the fibula. Prevent Talar tilt into Inversion.

Medial Ligaments of Ankle

Known collectively as the Deltoid Ligament the medial ligaments of the ankle attaches proximally to the Medial Malleolus and fan out to attach distally to the Talus, Calcaneus and Navicular via four adjacent and continuous parts. The deltoid ligament is triangular in shape and consists of a superficial and deep layer which connect the talus to the medial malleolus. It reinforces the joint capsule medially. Stabilise’s the ankle joint during eversion of the foot and prevents subluxation of the ankle joint. 

Ligaments	Description	Proximal Attachment	Distal Attachment	Role
Anterior Tibiotalar Ligament		Medial Malleolus	Head of Talus	Reinforces Ankle Joint. Contorl Plantarflexion & Eversion
Posterior Tibiotalar Ligament		Medial Malleolus	Talus Posteriorly	Control Dorsiflexion
Tibionavicular Ligament	Forms most anterior part of the Deltoid Ligament	Medial Malleolus	Dorsomedial aspect of Navicular	Reinforces Ankle Joint
Tibiocalcaneal Ligament	Very thin ligament	Medial Malleolus	Sustentaculum Tali	Reinforces Ankle Joint

Joint Capsule

the joint capsule is thin anteriorly & posteriorly but is supported bilaterally by strong collateral ligaments

Function

Motions Available

Talocrural Joint is a uniaxial hinge joint which has just 1° of Motion

Dorsiflexion 0° - 20° 

Plantarflexion 0° - 50°

Closed Packed Position

Maximum Dorsiflexion

Open Packed Position

10 ° Plantarflexion

Pathology/Injury

Ankle Arthrodesis

Ankle Impingement

Ankle Osteoarthritis

Ankle Osteochondral Lesions

Ankle Sprain

Ankle and Foot Fractures

Ankle and Foot Arthropathies

Procedures

Ankle Arthroplasty

Recent Related Research (from Pubmed)

Lower extremity function during gait in participants with first time acute lateral ankle sprain compared to controls.

Lower extremity coordination and symmetry patterns during a drop vertical jump task following acute ankle sprain.

Inter-joint coordination strategies during unilateral stance 6-months following first-time lateral ankle sprain.

Single-leg drop landing movement strategies 6 months following first-time acute lateral ankle sprain injury.

Lower Limb Landing Biomechanics in Subjects with Chronic Ankle Instability.

Effect of Tape on Dynamic Postural Stability in Subjects with Chronic Ankle Instability.

Immediate weight-bearing after ankle fracture fixation.

Assessment of standing balance in patients after ankle fractures.

Increased treatment durations lead to greater improvements in non-weight bearing dorsiflexion range of motion for asymptomatic individuals immediately following an anteroposterior grade IV mobilisation of the talus.

Patient-Based and Surgical Risk Factors for Thirty-Day Post-operative Complications and Mortality Following Ankle Fracture Fixation in Hospitalized Patients.

References

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