Superficial posterior tibiotalar ligament
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The superficial posterior tibiotalar ligament (SPTTL) is the most posteriorly located superficial component of the four superficial components of the deltoid ligament 1-3.
It runs almost in a slightly oblique posteriorly oriented fashion from the medial tibial malleolus to the talus 1,2. The superficial tibiotalar ligament becomes most tense in strain studies with dorsiflexion 3.
Its proximal insertion or origin is next to the distal center of the intercollicular groove of the medial malleolus.
The distal insertion is located on the posteroinferior medial talar body inferior to the insertion of the deep posterior tibiotalar ligament and anterior to the posteromedial talar tubercle 1.
In anatomical cadaver studies, it was reported to be absent in about 20% of the cases 1.
The superficial and deep components of the posterior talar ligament are not easy to differentiate from each other without proper knowledge of the normal anatomy. They have commonly a striated appearance on MRI with interjacent fat.
If this is of interest, differentiation works best on posteriorly oblique axial non-fat-saturated T2 or intermediate 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
- 3. Takao M, Ozeki S, Oliva X et al. Strain Pattern of Each Ligamentous Band of the Superficial Deltoid Ligament: A Cadaver Study. BMC Musculoskelet Disord. 2020;21(1):289. doi:10.1186/s12891-020-03296-0 - Pubmed