Ankle joint

The ankle joint forms the articulation between the foot and the leg. It is a primary hinge synovial hinge joint lined with hyaline cartilage.

Gross anatomy

The ankle joint is comprised of the tibia, fibula, talus, and calcaneus and as well as the supporting ligaments, muscles and vesselsneurovascular bundles. It carries the weight of the body and can undergo a myriad of pathology, most commonly traumatic relating toinjuries of the medial and lateral malleolusmalleoli.

The tibia extends inferiorly to articulate with the talus on its medial aspect which has a medial projection as the medial malleolus.

The fibula has a similar extension laterally as the lateral malleolus. The tibia has a partially curved surface to articulate with the talar dome which is wide anteriorly and narrows posteriorly.

The talus lies above the calcaneus and articulates with the navicular anteriorly.

The ligamentsof the ankle form a medial and lateral group each comprising of three main ligaments.

The deltoid ligament is medial and is made of two parts. The deep parts is the tibiotalar part. The superficial triangular (delta) part is a continuous band projecting from the apex of the medial malleolus to the medial tubercle of the talus, the sustentaculum tali of the calcaneus and the tuberosity of the navicular.  With fusion with the spring ligament also.

The lateral ligaments include the anterior and posteiroposterior talofibular ligament and the calcaneofibular ligament. These ligaments fuse with the joint capsule to enclose the joint so any fracture involgininvolving the joint will invoke an ankle effusion.The.The interosseous tibofibulartibiofibular ligament between the fibula and tibia is another important structure maintaining ankle stability.in in the subtalar region the spring ligament (calcaneonavicular) maintains the integrity of the region.

There is an anterio lateralanterolateral, posteromedial and lateral compartment of the ankle typically superficial to the joint.

The posterolateral compartment has tibialis posterior ligament, flexor digitorum longus ligament, the posterior tibial artery and tibial nerve and flexor hallicushallucis longus ligmentligament in that order anterior to posterior.

The anterior compartment under the extensor retinaculum is the tibialis anterior lig, extensor hallicushallucis longus, dorsalis pedis, deep peroneal nerve, externsorextensor digitorum.

In the peroneal compartment is peroneus longus, peroneus brevis, sural nerve and the terminal branch of peroneal artery. The anteriomedialThe anteromedial superficial area is the long saphenous vein and saphenous nercenerve.

Superficial Superficial to the peroneal compartment is the sural nerve and short saphenous vein.

Nerve supply

Tibial

• tibial nerve,
• deep peroneal nerve.

Blood supply

posterior

• anterior and anteriorposterior tibial artery, arteries
• peroneal artery.