The PTFL is the strongest of the three lateral ankle ligaments, running horizontally from the malleolar fossa to the posterior talus. It is rarely injured in isolation, only tearing in severe ankle dislocations when the ATFL and CFL have already failed. Its integrity maintains the talus in the mortise against posterior displacement.
| Origin | Malleolar fossa on the posterior lateral malleolus |
|---|---|
| Insertion | Posterior talar process (lateral tubercle) |
| Actions | The strongest lateral ankle ligament — resists extreme plantarflexion and posterior talar displacement |
|---|
PTFL injury indicates a severe ankle sprain or dislocation mechanism — isolated PTFL tears are exceedingly rare. Its thick fibrous construction provides substantial resistance to the posterior talar displacement that would produce ankle dislocation. MRI assessment after high-grade ankle sprains evaluates all three lateral ligaments.
Strongest lateral ankle ligament tear only in severe ankle dislocation following ATFL and CFL failure, indicating high-grade ligamentous ankle instability.
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