Anatomy of the lateral ankle ligaments.

The anatomy of the lateral ankle ligaments that is frequently described in articles and book chapters often lacks the precision of orientation and attachment points. We believe a knowledge of this precise anatomy is important to better reconstruct or repair lateral ligaments. We dissected cadaveric ankles free of skin and soft tissue and made the following measurements: areas of attachments of the anterior talofibular ligament, length and width of the anterior talofibular ligament, and locations of the attachments on the fibula and talus. The same measurements were made of the calcaneofibular and posterior talofibular ligaments. The distance of the calcaneofibular calcaneal attachments from the subtalar joint as well as the angle in the sagittal plane with the fibula was determined. We then used these anatomic attachments of the ligaments to make comparisons with the Watson-Jones and modified Elmslie reconstructions. Our results enable us to suggest a more anatomic placement for ligaments in a reconstruction.