Review Question - QID 3242

Figure A shows a lateral process talar fracture. Excision of a fragment of approximately 1 cubic centimeter is reported for acute injury as well as painful nonunion/fibrous union. Excision of this piece is shown to sacrifice the entire lateral talocalcaneal ligament as well as 10% of the anterior and posterior talofibular ligaments.

Langer et al performed a cadaveric biomechanical analysis of such an excision and found that ankle and subtalar instability were not created with simple excision of this fragment.

DiGiovanni et al found that only three ligaments attach to the lateral process of the talus: lateral talocalcaneal, anterior talofibular, and posterior talofibular, with the lateral talocalcaneal ligament inserting closest to the tip/apex of the lateral process.

Illustration A shows an anatomical drawing of the ligaments of the lateral ankle. Illustration B shows a cadaveric image of the ligaments of the lateral ankle. The numbers in Illustration B correspond to the following structures: 1- calcaneofibular ligament, 2-lateral talocalcaneal ligament, 3-anterior talofibular ligament, 4-peroneal tubercle.