Assessing the Anterior Talofibular and Calcaneofibular Ligaments

The part begins with the ligaments that support the talocrural, inferior tibiofibular and subtalar joints. Eamonn explains that injury to the anterior talofibular ligament reduces resistance to anterior translation, internal rotation and inversion of the talus, while injury to the calcaneofibular ligament, the main stabilizer of the subtalar joint, reduces resistance to inversion and internal rotation of the calcaneus. Palpation of the anterior talofibular ligament has high sensitivity: if palpation does not reproduce the patient's pain, the ligament is unlikely to be injured. He demonstrates palpating its full length with the ankle in slight plantarflexion, the rearfoot inverted and the foot internally rotated. The calcaneofibular ligament is harder to assess, since only about its distal third is palpable below the peroneal tendons. He shows how to find it, running at around 135 degrees from the tip of the lateral malleolus toward the heel, with the calcaneus slightly inverted.