The fibular collateral ligament (lateral collateral ligament) is a cord-like structure connecting the lateral femoral epicondyle to the fibular head, separated from the lateral meniscus by a fat pad. It is the primary static lateral knee stabiliser against varus stress.
Primary restraint against varus stress at all flexion angles (maximal at 30 degrees of flexion when the posterior capsule is relaxed), contributes to external rotation control, and is the key lateral component of the posterolateral corner complex.
FCL injury is assessed by varus stress testing at 0 and 30 degrees of flexion — isolated FCL tears produce laxity only at 30 degrees, while combined FCL and capsular injuries produce laxity at both angles. The figure-four position tenses the FCL maximally for palpation and stress testing.
FCL reconstruction using gracilis or Achilles allograft from lateral epicondyle to fibular head for symptomatic varus instability after failed conservative management.
FCL disruption as part of posterolateral corner injury producing combined varus and external rotation instability, requiring comprehensive PLC reconstruction including FCL, popliteofibular ligament, and popliteus tendon.
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