The CFL is the only lateral ankle ligament that crosses both the ankle and subtalar joints, providing lateral stability to both articulations simultaneously. It is taut in ankle dorsiflexion and neutral (while the ATFL is slack in this position). Grade II and III ankle sprains tear both the ATFL and CFL — the talar tilt test stresses the CFL specifically. The CFL lies deep to the peroneal tendons.
| Origin | Apex of the lateral malleolus (just posterior and inferior to the ATFL origin) |
|---|---|
| Insertion | Lateral calcaneal surface (just posterior to the peroneal tubercle) |
| Actions | Primary restraint against inversion in dorsiflexion and neutral; secondary restraint against subtalar inversion; both an ankle and subtalar ligament |
|---|
The CFL must be evaluated during Brostrom repair — if it is torn (confirmed by the positive talar tilt test), it should be repaired alongside the ATFL. The talar tilt test is performed with the ankle in neutral and the foot inverted — greater than 9 degrees indicates CFL involvement. The inferior extensor retinaculum Gould augmentation reinforces both ATFL and CFL repairs.
Combined ATFL and CFL disruption producing combined anterior drawer and talar tilt instability managed with Brostrom-Gould repair of both ligaments.
