12 in total
- 4 anterior
- 4 lateral
- 4 medial
Anterior
Suprapatellar
Prepatellar
Superficial & Deep Infrapatellar
Lateral
Biceps femoris - between biceps & LCL
LCL - between LCL & capsule over popliteus tendon
Lateral Gastrocnemius - between LG & capsule
Popliteus - between popliteus tendon & tibia & fibula
Rotational force incurred while joint partially flexed & extending
- caught between femoral & tibial condyles
- usually valgus & ER / varus & IR
LCL / Popliteus / Popliteofibular ligament
Laprade et al. AJSM 2003
https://pubmed.ncbi.nlm.nih.gov/14623649/
1. Lateral collateral ligament
Femoral attachment
Developmental Anatomy
Knee joint first appears as a mesenchymal cleft at 8 weeks gestation
- ACL and PCL separate entities by week 10
Type I: Undisplaced avulsion fracture
Type II: Anterior portion displaced & hinged
Type IIIA: Displaced
Type IIIB: Displaced & Rotated
Jacques LisFranc De St-Martin (1790 - 1847)
General Surgeon in Napoleonic army
High energy
1. Twisting / Abduction injury of forefoot
- original description is fall from horse with foot caught in stirrups
- MVA
2. Axial Loading
10% of calcaneus fractures
40% of crush injuries
High index of suspicion / classic signs less reliable
Pain & pain with passive stretch remain the cardinal signs
- pallor, paresthesia, pulselessness, & paralysis occur later or sometimes not at all
- low threshold calcaneal compartment pressures & surgical exploration
Chronic instability due to rupture of one or more parts of the lateral ligament
Progressive injury
1. Anterolateral capsule
2. ATFL
3. CFL
Can lead to ankle OA over time
Partial or complete rupture of one or parts of lateral ligaments of ankle
- common ankle sprain
Lateral ligaments sprains are the most common ligamentous injuries of the human body
- account for approximately 15% of all athletic injuries
- it is estimated that there is one ankle inversion injury per day per 10,000 people
Most common young males
- average age 27
- 90% load through plafond to talus
- 10% load through lateral talofibular articulation
A. Lateral Ligament Complex
ATFL (Anterior Talo-Fibular Ligament)
- tight in plantar flexion