TSL: Talospring ligament.
TCL: Talocalcaneal ligament.
PTTL: Posterior tibiotalar ligament.
ATTL: Anterior tibiotalar ligament.
2- Anatomically, no differentiation between different parts of deep and superficial ligaments except by tracing the origin and insertion of each one of them.
3- Each of them is arising from the inner surface of the medial malleolus and insert as his name say.
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| Coronal proton density-weighted fat-suppressed (left) and T1-weighted (right) images demonstrate the normal striated appearance of the posterior tibiotalar ligament (PTTL) in a 64 year-old female. The posterior tibial (PT) and flexor digitorum longus (FDL) tendon are indicated. |
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| A coronal proton density-weighted image (left) through the anterior colliculus of the medial malleolus demonstrates the normal anatomic relationships of the anterior tibiotalar ligament (ATTL) which extends from the tip of the anterior colliculus to the medial talus just anterior and inferior to its articular surface. An axial T1-weighted image demonstrates both the anterior tibiotalar ligament (ATTL) and the more substantial posterior tibiotalar ligament (PTTL) at the level of their talar insertions. The superficial component of the deltoid complex is composed primarily of fibers forming the tibiospring ligament (TSL) at this level and can be seen on the coronal and axial images as a low signal curvilinear band superficial to the deep components. The flexor retinaculum (FR), posterior tibial tendon (PT), flexor digitorum longus tendon (FDL), and superomedial portion of the spring ligament complex (SL) are also indicated. |
Inadequate healing are in the from of partially torn ligament with or without hypertrophied synovial tissue or in the form of thickened ligament.
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| (a) T1-weighted spin-echo MR image (600/20) shows the posterior tibiotalar ligament (arrows) as a short, thick band that extends from the tip of the medial malleolus to the medial talar surface. (b)Photograph of corresponding macroscopic section shows the posterior tibiotalar ligament (arrows). |
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| (a) T1-weighted spin-echo MR image (600/20) shows the posterior tibiotalar ligament (arrows) as a short, thick band that extends from the tip of the medial malleolus to the medial talar surface. (b)Photograph of corresponding macroscopic section shows the posterior tibiotalar ligament (arrows). |
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| 15 year-old female with acute inversion lateral ankle sprain. Axial T1-weighted (left) and coronal proton density-weighted fat-suppressed (right) images demonstrate loss of the normal striations of the PTTL with increased signal indicating edema and contusion (asterisks). |
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| Proximal (type I) avulsion of the tibionavicular ligament is demonstrated at the anterior margin of the anterior colliculus (arrows) and ill-defined, lax and edematous distal ligament fibers (arrowheads) are apparent. The patient also had a tear of the anterior inferior tibiofibular ligament and a non-displaced spiral fracture of the distal fibular shaft. |
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| 48 year-old male with chronic medial pain and multiple ankle sprains. Coronal fat-suppressed images through the posterior (left) and anterior (right) portion of the anterior colliculus demonstrate a chronic partial avulsion of the tibiospring ligament (arrowheads). On the more anterior slice the tibionavicular ligament (arrow) is abnormally thickened and low in signal indicating fibrosis from remote trauma. The posterior tibial tendon (PT) and superomedial portion of the spring ligament complex (SL) are labeled. |
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