Deep posterior tibiotalar ligament
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The deep posterior tibiotalar ligament (DPTTL) is one of the two deep components and the strongest part of the deltoid ligament 1,2.
The deep posterior tibiotalar ligament is covered by the superficial posterior tibiotalar and tibiocalcaneal ligaments. It is a broad and thick ligament that connects the medial tibial malleolus to the talus 1,2.
The origin of the deep posterior tibiotalar ligament is located near the distal center of the intercollicular groove of the medial malleolus.
The talar insertion is beneath and superior to the insertion of the superficial posterior tibiotalar ligament on the posterosuperior aspect of the medial talar body just below the articular surface of the trochlea 1.
It shows a striated appearance on MRI with interjacent fatty streaks and is difficult to differentiate from its superficial counterpart. This is best achieved on posteriorly oblique axial non-fat-saturated T2 weighted or proton density-weighted images.
- 1. Campbell K, Michalski M, Wilson K et al. The Ligament Anatomy of the Deltoid Complex of the Ankle: A Qualitative and Quantitative Anatomical Study. J Bone Joint Surg Am. 2014;96(8):e62. doi:10.2106/JBJS.M.00870 - Pubmed
- 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. doi:10.2214/AJR.08.2286 - Pubmed