The ATFL is the most commonly injured ligament in the human body, torn in the vast majority of lateral ankle sprains during the plantarflexion-inversion mechanism. It is the weakest of the three lateral ankle ligaments. The anterior drawer test of the ankle specifically stresses the ATFL by applying an anterior force to the calcaneus with the ankle in slight plantarflexion.
| Origin | Anterior border of the lateral malleolus |
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| Insertion | Lateral surface of the talar neck |
| Actions | Primary restraint against anterior talofibular displacement and internal rotation of the talus; taut in plantarflexion-inversion |
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ATFL tears are graded I (stretch), II (partial tear), and III (complete tear). Most heal well with functional rehabilitation — RICE, early protected weight bearing, and progressive proprioceptive training. Chronic ankle instability from recurrent ATFL injuries is managed with the Brostrom-Gould anatomical repair or lateral ankle ligament reconstruction. The ATFL is visualised on ultrasound as a hypoechoic band between the lateral malleolus and the talar neck.
ATFL tear from plantarflexion-inversion injury, the most common sports ligament injury globally, managed with RICE and functional rehabilitation with surgical repair reserved for chronic instability.
