The posterior proximal tibiofibular ligaments form a part of the proximal tibiofibular joint capsule and belong to the supporting structures of the proximal tibiofibular joint.
On this page:
Gross anatomy
The posterior proximal tibiofibular ligaments are thinner and less strong than the anterior proximal tibiofibular ligaments 1,2. Up to three bundles have been described: one thin broad superior bundle and a bundle at the mid-level of the joint both running obliquely and one inferiorly which might be viewed as a reinforcement and is inconsistently present radiating from the soleus muscle 1,2.
Attachments
The superior reinforcement originates at the posterolateral tibial condyle and inserts at the superoposterior aspect of the fibular styloid process, just medial to the insertion of the popliteofibular ligament 2.
The stronger middle bundle has its attachments at the posteromedial aspect of the fibular head just inferior to the superior bundle and posterior proximal tibia medial and inferior to the superior bundle 2.
The insertions of the inferior bundle, if present, are located at the proximal tibia superior to the soleus line and the fibular neck 2.
Variant anatomy
The inferior bundle was reported in one study in up to 25% of the cases 1.
Radiographic features
Ultrasound
In contrast to the anterior tibiofibular ligaments, the posterior tibiofibular ligaments seem to show a hypoechoic appearance and are visualized less frequent. It seems that the superior bundle might be discernable on ultrasound in about 80-90%, the middle bundle in about half of the cases and the inferior bundle very rarely if not at all 3.
MRI
Like other ligaments imaging appearance of the proximal tibiofibular ligaments is hypointense.
Related pathology
Injury to the posterior proximal tibiofibular ligament can result in the following clinical conditions 3:
- anterolateral proximal tibiofibular joint dislocation
- proximal tibiofibular instability