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Anatomy and Biomechanics of the Foot and Ankle

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Ligamentous Injuries of the Foot and Ankle

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Abstract

The foot and the ankle form a complex anatomical system that allows to dynamically vary its conformation during the gait cycle. To allow these physiological conformation changes while maintaining adequate stability, bone congruence and tenacious ligamentous and tendon structures are needed.

The stabilizers of the distal tibiofibular syndesmosis are four: the anterior inferior tibiofibular ligament (AITFL), the posterior inferior tibiofibular ligament (PITFL), the interosseous ligament (IOL), and the inferior transverse ligament (ITL). These ligaments, associated to the bone congruence, contribute to axial, rotational, and translational stability.

The ankle lateral ligament complex consists of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL), while the medial ligament complex is a robust two-layer ligamentous system.

The subtalar ligaments can be divided into intrinsic (cervical ligament, CL; interosseous talocalcaneal ligament, ITCL; the roots of the inferior extensor retinaculum; the anterior talocalcaneal ligament, ATCL or ACaL) and extrinsic (calcaneofibular ligament, CFL; tibiocalcaneal fascicle of the deltoid ligament).

The midtarsal joint complex, or Chopart joint, represents the anatomical connection between the midfoot and the hindfoot. Among the main ligament structures of the foot, the one of greater anatomical and biomechanical complexity is the spring ligament complex.

The midfoot is composed of a bone and ligamentous complex; the distal portion is the tarsometatarsal joint complex, also known as Lisfranc joint complex, that encompasses the bases of the five metatarsal bones and their respective joint surfaces for the three cuneiform bones and cuboid.

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Acknowledgments

Authors would like to thank Dr. Silvio Caravelli, MD (II Clinic of Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna) and Dr. Maria Pia Cumani (Scuola di Disegno Anatomico, IRCCS Istituto Ortopedico Rizzoli, Bologna) for artwork and figures.

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Authors and Affiliations

  1. IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Alberto Grassi & Massimiliano Mosca

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  1. Alberto Grassi
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  2. Massimiliano Mosca
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Correspondence to Alberto Grassi .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

    Pieter D’Hooghe

  2. Department of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Kenneth J. Hunt

  3. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Jeremy J. McCormick

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Grassi, A., Mosca, M. (2022). Anatomy and Biomechanics of the Foot and Ankle. In: D’Hooghe, P., Hunt, K.J., McCormick, J.J. (eds) Ligamentous Injuries of the Foot and Ankle. Springer, Cham. https://doi.org/10.1007/978-3-031-08682-3_2

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  • DOI: https://doi.org/10.1007/978-3-031-08682-3_2

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