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the middle of the three fascicles that form the lateral ligament of the ankle joint, reinforcing the lateral side of the ankle joint and resisting excessive inversion of the foot; the remaining two ligaments of the lateral ligaments are the anterior and posterior talofibular ligaments.
Synonym(s): ligamentum calcaneofibulare [TA]
calcaneofibular ligamentThe narrow rounded middle fascicle of the 3-part lateral ankle ligament, which counters excess foot inversion. It courses from the apex of the fibular malleolus inferoposteriorly to a tubercle on the lateral calcaneus. Sprains cause 85% of ankle injuries, of which 85% are inversion injuries involving the lateral ligaments, primarily the anterior talofibular ligament, closely followed by the calcaneofibular ligament.
RICE—rest, ice, compression, and elevation—are the mainstays of early management; surgery for grade-III sprains, especially for young professional athletes.
calcaneofibular ligamentAbbreviation: CFL
An extracapsular ligament of the lateral ankle joint. The calcaneofibular ligament originates from the inferior apex of the lateral malleolus and courses at approximately a 133° angle to attach to the calcaneus. It is the primary restraint against talar inversion when the ankle is in its neutral position.
See also: ligament
calcaneofibular ligament; CFL extra-capsular, cord-like ligament crossing ankle and subtalar joints; originates at distal inferior surface of fibula and inserts into tubercle on lateral aspect of calcaneum, deep to the peroneal tendons; strongly resists calcaneal inversion (see Table 1)
|Type||Characteristics of the injury to the ankle ligament|
|Grade I||History of mild inversion injury|
|Overstretching of lateral collateral ligament + microscopic tears of ATFL fibres|
|Stable ankle joint but some restriction in range of motion/weight-bearing|
|Mild local swelling without bruising/ecchymosis along lateral border of ankle|
|Pinpoint area of tenderness overlying area of ligament injury|
|Grade II||History of moderate inversion injury|
|Complete tear of ATFL and partial tear of CFL|
|Mild/moderate ankle instability with restricted range of motion|
|Moderate swelling over anterior lateral aspect of ankle with marked soft-tissue bruising/ecchymosis or haemorrhage in area of injury|
|Marked pain on direct palpation of ATFL|
|Grade III||History of severe inversion injury|
|Complete tear of ATFL, CFL and underlying joint capsule|
|Marked instability and laxity of ankle with positive anterior drawer test, talar inversion tilt and inability to evert foot at subtalar joint|
|Severe swelling along lateral border of ankle and heel with marked haemorrhage and ecchymosis|
|Discrete pain and tenderness of soft tissues overlying ATFL, CFL and anterolateral joint capsule|
ATFL, anterior talofibular ligament; CFL, calcaneofibular ligament.