Anterior inferior tibiofibular ligament

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The anterior inferior tibio-fibular ligament (AITFL) is part of the lateral collateral ligament complex of the ankle

Gross anatomy

It generally has a trapezoidal shape, with multiple bands of fibers that extends obliquely in a distal and lateral direction from the tibia to the fibula 1. It usually becomes thicker from superior to inferior.

It starts from the distal tibia at around 5 mm above the articular surface, and descends obliquely between the adjacent margins of the tibia and fibula, anterior to the syndesmosis to the anterior aspect of the lateral malleolus. Length ranges from 12 - 20-20 mm and thickness 1 to 3-3 mm.

Width range 3:

  • 7 - 12-12 mm at fibular insertion to
  • 9 - 22-22 mm at the tibial insertion
Classification 

On classification method according to Ray and Kriz is as follows 3

  • type 1: multiple fascicles (more than three) with or without small gaps between adjacent fascicles
    • type 1a: inferior fascicle separated from the rest of the ligament by a gap and possesses its own distinct proximal and distal attachments
    • type 1b: inferior fascicle is not completely separated from the rest of the ligament by a gap; either its proximal or its distal attachment is continuous with rest of the ligament
    • type 1c: multiple fascicles without gaps intervening between them
  • type 2: three fascicles or less; distinct inferior fascicle with both its proximal and distal attachments separate from rest of the ligament; inferior fascicle separated completely from the main portion of the ligament by a gap
  • type 3: three fascicles or less; distinct inferior fascicle with either its proximal or its distal attachment continuous with the rest of the ligament; gap does not completely separate the inferior fascicle from rest of the ligament
  • type 4: three fascicles or less; lower portion of the ligament possesses an inferior fascicle with both its proximal and distal attachments for the rest of the ligament
  • type 5: three fascicles or less; igament with no separations or gaps within its structure and may or may not possess a fascicular arrangement

Variant anatomy 

  • -<p>The <strong>anterior inferior tibio-fibular ligament (AITFL)</strong> is part of the <a href="/articles/lateral-collateral-ligament-of-the-ankle">lateral collateral ligament complex of the ankle</a>. </p><h4>Gross anatomy</h4><p>It generally has a trapezoidal shape, with multiple bands of fibers that extends obliquely in a distal and lateral direction from the tibia to the fibula<sup> 1</sup>. It usually becomes thicker from superior to inferior.</p><p>It starts from the distal tibia at around 5 mm above the articular surface, and descends obliquely between the adjacent margins of the tibia and fibula, anterior to the syndesmosis to the anterior aspect of the lateral malleolus. Length ranges from 12 - 20 mm and thickness 1 to 3 mm.</p><p>Width range <sup>3</sup>:</p><ul>
  • -<li>7 - 12 mm at fibular insertion to</li>
  • -<li>9 - 22 mm at the tibial insertion </li>
  • +<p>The <strong>anterior inferior tibio-fibular ligament (AITFL)</strong> is part of the <a href="/articles/lateral-collateral-ligament-of-the-ankle">lateral collateral ligament complex of the ankle</a>. </p><h4>Gross anatomy</h4><p>It generally has a trapezoidal shape, with multiple bands of fibers that extends obliquely in a distal and lateral direction from the tibia to the fibula<sup> 1</sup>. It usually becomes thicker from superior to inferior.</p><p>It starts from the distal tibia at around 5 mm above the articular surface, and descends obliquely between the adjacent margins of the tibia and fibula, anterior to the syndesmosis to the anterior aspect of the lateral malleolus. Length ranges from 12-20 mm and thickness 1-3 mm.</p><p>Width range <sup>3</sup>:</p><ul>
  • +<li>7-12 mm at fibular insertion to</li>
  • +<li>9-22 mm at the tibial insertion</li>
  • -<a title="Accessory anterior inferior tibiofibular ligament" href="/articles/accessory-anterior-inferior-tibiofibular-ligament">accessory anterior inferior tibiofibular ligament</a>  / <a title="Bassett's ligament" href="/articles/accessory-anterior-inferior-tibiofibular-ligament">Bassett's ligament</a>
  • +<a href="/articles/accessory-anterior-inferior-tibiofibular-ligament">accessory anterior inferior tibiofibular ligament</a>  / <a href="/articles/accessory-anterior-inferior-tibiofibular-ligament">Bassett's ligament</a>

References changed:

  • 1. Boonthathip M, Chen L, Trudell D, Resnick D. Tibiofibular Syndesmotic Ligaments: MR Arthrography in Cadavers with Anatomic Correlation. Radiology. 2010;254(3):827-36. <a href="https://doi.org/10.1148/radiol.09090624">doi:10.1148/radiol.09090624</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/20177095">Pubmed</a>
  • 2. Perrich K, Goodwin D, Hecht P, Cheung Y. Ankle Ligaments on MRI: Appearance of Normal and Injured Ligaments. AJR Am J Roentgenol. 2009;193(3):687-95. <a href="https://doi.org/10.2214/AJR.08.2286">doi:10.2214/AJR.08.2286</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/19696282">Pubmed</a>
  • 3. van den Bekerom M & Raven E. The Distal Fascicle of the Anterior Inferior Tibiofibular Ligament as a Cause of Tibiotalar Impingement Syndrome: A Current Concepts Review. Knee Surg Sports Traumatol Arthrosc. 2007;15(4):465-71. <a href="https://doi.org/10.1007/s00167-006-0275-7">doi:10.1007/s00167-006-0275-7</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/17237964">Pubmed</a>

Systems changed:

  • Musculoskeletal
Images Changes:

Image 2 Ultrasound (Longitudinal) ( create )

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