Superficial posterior tibiotalar ligament

Last revised by Joachim Feger on 20 Nov 2021

The superficial posterior tibiotalar ligament (SPTTL) is the most posteriorly located superficial component of the four superficial components of the deltoid ligament 1-3.

The superficial posterior tibiotalar ligament is located superficial to the deep posterior tibiotalar ligament and posterior to the tibiocalcaneal ligament.

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.

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