Complex retinacular structure constraining and in parts enveloping the anterior tendons and neurovascular bundle
Comprises a superior and inferior component
The superior crosses the anterior tibia above the tibiotalar joint
The inferior is Y shaped with a lateral attachment on the talus and calcaneum
and two medial attachments on the distal tibia and navicular
The inferior invests the extensor digitorum and tibialis anterior tendons.
Can be torn in both low and high ankle sprain, the letter is nore common
Look for lateral tears when the anterior talofibular ligament is torn
A sclerosing type of retinacular disease can occur leading to somression and possibly rupture of the tibialis anterior tendon
This can be the result of trauma, it is more common in diabetics
BIFURCATE LIGAMENT
Has two components. The lateral portion is the medial calcaneocuboid ligament, which lies on the superior aspect of the cuboid. Medial is the dorsolateral calcaneocuboid ligament The proximal insertion of the ligament is on the anterior process of the os calcis. Injuries are generally caused by inversion of the mid-foot. May have associated fractures of the anterior process Also be associated with fractures of the base of the fifth metatarsal.
TALONAVICULAR LIGAMENT
A short ligament that reinforces the capsule on the dorsal aspect of the talonavicular joint Its lateral relationship is with the medial limb of the bifurcate ligament. The spring ligament lies in its medial aspect. Enthesopathy of the talonavicular ligament is reported in footballers secondary to chronic impaction. Increase thickening, loss of reflectivity and increased doppler activity are the characteristic features. The differential diagnosis is a stress fracture of the navicular.