Distal Tibiofibular Syndesmosis: Difference between revisions
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The distal tibiofibular syndesmosis is a syndesmotic joint. It is formed between the distal tibia and fibula and it is attached by the interosseous ligament (IOL) | The distal tibiofibular syndesmosis is a syndesmotic joint. It is formed between the distal tibia and fibula and it is attached by the interosseous ligament (IOL) | ||
and 3 major ligaments: the anterior-inferior tibiofibular ligament (ATIFL), the posterior-inferior tibiofibular ligament (PTIFL) and the transverse tibio-fibular ligament (TTFL). <ref name="Hermans" /><ref name="Lin">Lin CF, Gross MT, Weinhold P. Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention. Journal of Orthopaedic &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Sports Physical Therapy. 2006 Jun;36(6):372-84.</ref> | and 3 major ligaments: the anterior-inferior tibiofibular ligament (ATIFL), the posterior-inferior tibiofibular ligament (PTIFL) and the transverse tibio-fibular ligament (TTFL). <ref name="Hermans" /><ref name="Lin">Lin CF, Gross MT, Weinhold P. Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention. Journal of Orthopaedic &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Sports Physical Therapy. 2006 Jun;36(6):372-84.</ref> | ||
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=== Motions Available === | === Motions Available === | ||
{| width=" | {| width="200" border="1" align="center" cellpadding="1" cellspacing="1" | ||
|+ Distal Tibiofibular Syndesmosis Ligaments | |+ Distal Tibiofibular Syndesmosis Ligaments | ||
|- | |- | ||
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|+ SYNDESMOSIS LIGAMENTS | |+ SYNDESMOSIS LIGAMENTS | ||
|- | |- | ||
| '''LIGAMENT''' | | '''LIGAMENT''' | ||
| '''DESCRIPTION''' | | '''DESCRIPTION''' | ||
| '''PROXIMAL ATTACHMENT''' | | '''PROXIMAL ATTACHMENT''' | ||
| '''DISTAL ATTACHMENT''' | | '''DISTAL ATTACHMENT''' | ||
| '''ROLE / FUNCTION''' | | '''ROLE / FUNCTION''' | ||
|- | |- | ||
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|- | |- | ||
| Posterior or posterior-inferior tibiofibular ligament (PTIFL) | | Posterior or posterior-inferior tibiofibular ligament (PTIFL) | ||
| Strong compact ligament. Known as the Superficial component of the PTIFL. | | Strong compact ligament. Known as the Superficial component of the PTIFL. | ||
| | | | ||
Posterior edge of the lateral malleolus | Posterior edge of the lateral malleolus | ||
| Posterior tibial tubercle. | | Posterior tibial tubercle. | ||
| | | | ||
|- | |- | ||
| Transverse ligament | | Transverse ligament | ||
| Also known as the Deep component of the PTIFL. Cone shaped. | | Also known as the Deep component of the PTIFL. Cone shaped. | ||
| Proximal area of the malleolar fossa | | Proximal area of the malleolar fossa | ||
| Posterior edge of the tibia -- directly posterior to the cartilaginous covering of the inferior tibial articular surface and may extent up to the medial malleolus. | | Posterior edge of the tibia -- directly posterior to the cartilaginous covering of the inferior tibial articular surface and may extent up to the medial malleolus. | ||
| | | | ||
*Forms a true labrum. | *Forms a true labrum. | ||
*Provides talocrural joint stability. | *Provides talocrural joint stability. | ||
*Prevents Posterior translation | *Prevents Posterior translation | ||
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The superficial component originates at the posterior edge of the lateral malleolus and directs proximally and medially to insert in the posterior tibial tubercle. This component would be homologous to the anterior tibiofibular ligament. The term posterior or posteroinferior tibiofibular ligament is usually used to refer to the superficial component (Figs. 20, ,2121). | The superficial component originates at the posterior edge of the lateral malleolus and directs proximally and medially to insert in the posterior tibial tubercle. This component would be homologous to the anterior tibiofibular ligament. The term posterior or posteroinferior tibiofibular ligament is usually used to refer to the superficial component (Figs. 20, ,2121). | ||
<br> | |||
The deep component is cone shaped and originates in the proximal area of the malleolar fossa to insert in the posterior edge of the tibia. Its insertion is immediately posterior to the cartilaginous covering of the inferior tibial articular surface; the fibers may reach the medial malleolus (Fig. 21). This component is also known as the transverse ligament, forming a true labrum [36] to provide talocrural joint stability and to prevent posterior talar translation [37].<br> | The deep component is cone shaped and originates in the proximal area of the malleolar fossa to insert in the posterior edge of the tibia. Its insertion is immediately posterior to the cartilaginous covering of the inferior tibial articular surface; the fibers may reach the medial malleolus (Fig. 21). This component is also known as the transverse ligament, forming a true labrum [36] to provide talocrural joint stability and to prevent posterior talar translation [37].<br> | ||
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== Pathology/Injury == | == Pathology/Injury == | ||
{Although the syndesmosis is a joint, in the literature the term syndesmotic injury is used to describe injury of the syndesmotic ligaments.<ref name="Hermans" />}link | {Although the syndesmosis is a joint, in the literature the term syndesmotic injury is used to describe injury of the syndesmotic ligaments.<ref name="Hermans" />}link | ||
Clinical conditions<br>high ankle sprain & syndesmosis injury <br>ankle fracture | Clinical conditions<br>high ankle sprain & syndesmosis injury <br>ankle fracture | ||
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Description[edit | edit source]
A syndesmosis is a fibrous joint between two bones and linked by ligaments and a strong membrane. [1]
The distal tibiofibular syndesmosis is a syndesmotic joint. It is formed between the distal tibia and fibula and it is attached by the interosseous ligament (IOL)
and 3 major ligaments: the anterior-inferior tibiofibular ligament (ATIFL), the posterior-inferior tibiofibular ligament (PTIFL) and the transverse tibio-fibular ligament (TTFL). [1][2]
Anatomy[edit | edit source]
Articulating Surfaces[edit | edit source]
Ligaments & Joint Capsule
[edit | edit source]
Muscles[edit | edit source]
Function[edit | edit source]
Motions Available[edit | edit source]
| LIGAMENT | DESCRIPTION | PROXIMAL ATTACHMENT | DISTAL ATTACHMENT | ROLE /FUNCTION |
|---|---|---|---|---|
| Distal anterior tibiofibular ligament (ATIFL) | ||||
| ONE | ||||
| TWO | ||||
| THREE | ||||
| FOUR |
| LIGAMENT | DESCRIPTION | PROXIMAL ATTACHMENT | DISTAL ATTACHMENT | ROLE / FUNCTION |
| Distal anterior tibiofibular ligament (ATIFL) |
||||
| Posterior or posterior-inferior tibiofibular ligament (PTIFL) | Strong compact ligament. Known as the Superficial component of the PTIFL. |
Posterior edge of the lateral malleolus |
Posterior tibial tubercle. | |
| Transverse ligament | Also known as the Deep component of the PTIFL. Cone shaped. | Proximal area of the malleolar fossa | Posterior edge of the tibia -- directly posterior to the cartilaginous covering of the inferior tibial articular surface and may extent up to the medial malleolus. |
|
| 4 | ||||
| 5 |
The superficial component originates at the posterior edge of the lateral malleolus and directs proximally and medially to insert in the posterior tibial tubercle. This component would be homologous to the anterior tibiofibular ligament. The term posterior or posteroinferior tibiofibular ligament is usually used to refer to the superficial component (Figs. 20, ,2121).
The deep component is cone shaped and originates in the proximal area of the malleolar fossa to insert in the posterior edge of the tibia. Its insertion is immediately posterior to the cartilaginous covering of the inferior tibial articular surface; the fibers may reach the medial malleolus (Fig. 21). This component is also known as the transverse ligament, forming a true labrum [36] to provide talocrural joint stability and to prevent posterior talar translation [37].
Range of Motion[edit | edit source]
Closed Packed Position[edit | edit source]
Open Packed Position[edit | edit source]
Osteokinematics[edit | edit source]
Arthrokinematics[edit | edit source]
Pathology/Injury[edit | edit source]
{Although the syndesmosis is a joint, in the literature the term syndesmotic injury is used to describe injury of the syndesmotic ligaments.[1]}link
Clinical conditions
high ankle sprain & syndesmosis injury
ankle fracture
Techniques[edit | edit source]
Palpation[edit | edit source]
Examination[edit | edit source]
Treatment[edit | edit source]
Resources[edit | edit source]
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ 1.0 1.1 1.2 Hermans JJ, Beumer A, De Jong TA, Kleinrensink GJ. Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach. Journal of anatomy. 2010 Dec 1;217(6):633-45.
- ↑ Lin CF, Gross MT, Weinhold P. Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention. Journal of Orthopaedic &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Sports Physical Therapy. 2006 Jun;36(6):372-84.
