Anatomy of the Ankle Joint and Hindfoot

  • Miki Dalmau-PastorEmail author
  • Matteo Guelfi
  • Francesc Malagelada
  • Rosa M. Mirapeix
  • Jordi Vega


The ankle is a highly congruent synovial, hinge-type joint, in which the talus fits perfectly into the mortise formed by the tibial plateau, and the tibial and fibular malleoli. This anatomical conformation allows movement through only one axis, the bimalleolar axis, through which dorsiflexion and plantarflexion movements are produced. Normal values of the range of motion are 13–33° for dorsiflexion and 23–56° for plantarflexion [1].


Ankle anatomy Anatomy Ankle Ankle arthroscopy Arthroscopic ankle anatomy Ankle ligaments Ankle joint Hindfoot anatomy 


  1. 1.
    Golanó P, Dalmau-Pastor M, Vega J, et al. Anatomy of the ankle. In: d’Hooghe PPRN, Kerkhoffs GMMJ, editors. The ankle in football, sports and traumatology. Heidelberg: Springer; 2014. p. 1–24.Google Scholar
  2. 2.
    Oliva XM, Rios JM, Guelfi M. Arthroscopy of subtalar joint. In: Randelli P, et al., editors. Arthroscopy: basic to advanced. Heidelberg: Springer; 2016. p. 1079–87.CrossRefGoogle Scholar
  3. 3.
    Kapanji IA. Cuadernos de fisiología articular. Masson, S.A., Barcelona: Cuaderno III; 1982. [in Spanish].Google Scholar
  4. 4.
    Michelson JD, Helgemo SL Jr. Kinematics of the axially loaded ankle. Foot Ankle Int. 1995;16:577–82.CrossRefGoogle Scholar
  5. 5.
    Espinosa N, Smerek JP, Myerson MS. Acute and chronic syndesmosis injuries: pathomechanisms, diagnosis and management. Foot Ankle Clin. 2006;11:639–57.CrossRefGoogle Scholar
  6. 6.
    Tol JL, Van Dijk CN. Etiology of the anterior ankle impingement syndrome: a descriptive anatomical study. Foot Ankle Int. 2004;25:382–6.CrossRefGoogle Scholar
  7. 7.
    Golanó P, Vega J, Pérez-Carro L, et al. Ankle anatomy for the arthroscopist. Part I: the portals. Foot Ankle Clin. 2006;11:253–73.CrossRefGoogle Scholar
  8. 8.
    Sarrafian SK. Anatomy of the foot and ankle. Descriptive, topographic, functional. 2nd ed. Philadelphia: Lippincott; 1993. p. 159–217.Google Scholar
  9. 9.
    Niek van Dijk C. Ankle arthroscopy. Heidelberg: Springer; 2014.CrossRefGoogle Scholar
  10. 10.
    van den Bekerom MPJ, Raven EEJ. The distal fascicle of the anterior inferior tibiofibular ligament as a cause of tibiotalar impingement syndrome: a current concepts review. Knee Surg Sports Traumatol Arthosc. 2007;15:465–71.CrossRefGoogle Scholar
  11. 11.
    Vega J, Peña F, Golanó P. Minor or occult ankle instability as a cause of anterolateral pain after ankle sprain. Knee Surg Sports Traumatol Arthrosc. 2016;24:1116–24.CrossRefGoogle Scholar
  12. 12.
    Golanó P, Vega J, de Leeuw PAJ, et al. Anatomy of the ankle ligaments: a pictorial essay. Knee Surg Sports Traumatol Arthrosc. 2010;18(5):557–69.CrossRefGoogle Scholar
  13. 13.
    Golanó P, Mariani PP, Rodríguez-Niedenfuhr M. Arthroscopic anatomy of the posterior ankle ligaments. Arthroscopy. 2002;18(4):353–8.CrossRefGoogle Scholar
  14. 14.
    Taylor DC, Englehardt DL, Bassett FH. Syndesmosis sprains of the ankle: the influence of heterotopic ossification. Am J Sports Med. 1992;20(2):146–50.CrossRefGoogle Scholar
  15. 15.
    Oh CS, Won HS, Chung IH, et al. Anatomic variations and MRI of intermalleolar ligament. AJR Am J Roentgenol. 2006;186(4):943–7.CrossRefGoogle Scholar
  16. 16.
    van Dijk CN. On diagnostic strategies in patient with severe ankle sprain. Thesis, University of Amsterdam, The Netherlands. 1994.Google Scholar
  17. 17.
    Burks RT, Morgan J. Anatomy of the lateral ankle ligaments. Am J Sports Med. 1994;22(1):72–7.CrossRefGoogle Scholar
  18. 18.
    Milner CE, Soames RW. Anatomical variations of the anterior talofibular ligament of the human ankle joint. J Anat. 1997;191:457–8.CrossRefGoogle Scholar
  19. 19.
    Vega J, Malagelada F, Manzanares Céspedes MC, Dalmau-Pastor M. The lateral fibulotalocalcaneal ligament complex: an ankle stabilizing isometric structure. Knee Surg Sports Traumatol Arthrosc. 2018;
  20. 20.
    Dalmau-Pastor M, Malagelada F, Kerkhoffs GM, Karlsson J, Guelfi M, Vega J. Redefining anterior ankle arthroscopic anatomy: medial and lateral ankle collateral ligaments are visible through dorsiflexion and non-distraction anterior ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2019;
  21. 21.
    McKeon KE, Wright RW, Johnson JE, et al. Vascular anatomy of the tibiofibular syndesmosis. J Bone Joint Surg. 2012;94:931–8.CrossRefGoogle Scholar
  22. 22.
    Kumai T, Takakura Y, Rufai A, et al. The functional anatomy of the human anterior talofibular ligament in relation to ankle sprains. J Anat. 2002;200:457–65.CrossRefGoogle Scholar
  23. 23.
    Vega J, Malagelada F, Karlsson J, Kerkhoffs GMMJ, Guelfi M, Dalmau-Pastor M. A step-by-step arthroscopic examination of the anterior ankle compartment. Knee Surg Sports Traumatol Arthrosc.
  24. 24.
    Broström L. Sprained ankles. VI. Surgical treatment of “chronic” ligament ruptures. Acta Chir Scand. 1966;132:551–65.Google Scholar
  25. 25.
    Colville MR, Marder RA, Boyle JJ, et al. Strain measurement in lateral ankle ligaments. Am J Sports Med. 1990;18:196–200.CrossRefGoogle Scholar
  26. 26.
    Boss AP, Hintermann B. Anatomical study of the medial ankle ligament complex. Foot Ankle Int. 2002;23:547–53.CrossRefGoogle Scholar
  27. 27.
    Milner CE, Soames RW. Anatomy of the collateral ligaments of the human ankle joint. Foot Ankle Int. 1998;19:757–60.CrossRefGoogle Scholar
  28. 28.
    Cromeens BP, Kirchhoff C, Patterson RM, et al. An attachment-based description of the medial collateral and spring ligament complexes. Foot Ankle Int. 2015;36:710–21.CrossRefGoogle Scholar
  29. 29.
    Rein S, Hagert E, Schneiders W, et al. Histological analysis of the structural compositison of ankle ligaments. Foot Ankle Int. 2015;36:211–24.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Miki Dalmau-Pastor
    • 1
    • 2
    Email author
  • Matteo Guelfi
    • 3
    • 4
  • Francesc Malagelada
    • 5
  • Rosa M. Mirapeix
    • 4
  • Jordi Vega
    • 1
    • 6
  1. 1.Laboratory of Arthroscopic and Surgical Anatomy, Department of Pathology and Experimental Therapeutics (Human Anatomy Unit)University of BarcelonaBarcelonaSpain
  2. 2.GRECMIP–MIFAS (Groupe de Recherche et d’Etude en Chirurgie Mini-Invasive du Pied–Minimally Invasive Foot and Ankle Society)MerignacFrance
  3. 3.Foot and Ankle Unit, Clinica MontallegroGenoaItaly
  4. 4.Human Anatomy and Embryology Unit, Department of Morphological SciencesUniversitad Autònoma de BarcelonaBarcelonaSpain
  5. 5.Department of Trauma and Orthopedic Surgery, Royal London HospitalBarts Health NHS TrustLondonUK
  6. 6.Foot and Ankle Unit, iMove Tres TorresBarcelonaSpain

Personalised recommendations