Anatomical study of the posterior talofibular ligament: A descriptive analysis of its dual-bundle structure

Background: The lateral ankle ligament complex, consisting of the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL), is essential for ankle stability. While the ATFL and CFL are frequently studied, the PTFL's role remains less explored.

Methods: Twelve fresh-frozen ankle specimens were dissected to analyze the PTFL's origin, trajectory, and talar insertion, focusing on its bundles and anatomical relationships.

Results: All specimens exhibited a consistent PTFL origin at the lateral malleolar fossa. Two distinct bundles were identified: the pars superficialis (PS) and pars profunda (PP). The PS attached to the posterolateral talus, while the PP attached separately to the posterior aspect of the lateral talar process.

Conclusion: The PTFL comprises two distinct bundles with separate talar insertions. This finding challenges the traditional view of a single-bundled PTFL and may influence understanding of lateral ankle instability as well as its treatment.

Level of evidence: IV.