The PTFL is the strongest lateral ankle ligament, running nearly horizontally from the posterior fibula to the posterior talar process. It is rarely torn in isolation — its disruption requires the extreme force of complete ankle dislocation. In Brostrom-Gould repair, the PTFL is typically preserved, providing a stable posterior anchor. Posterior ankle impingement from the PTFL and posterior talar process in extreme plantarflexion is the ballet dancer's posterior ankle pain.
| Origin | Posterior border of the lateral malleolus (posterior malleolar fossa) |
|---|---|
| Insertion | Posterior talar process (lateral tubercle) |
| Actions | Strongest lateral ankle ligament (tensile strength 260 N); resists posterior talar translation; only torn in complete ankle dislocation |
|---|
PTFL-posterior talar process impingement in dancers and footballers produces posterior ankle pain on extreme plantarflexion (the en-pointe position or when striking the ball). The os trigonum (unfused posterior talar process) is a common MRI finding in posterior impingement syndrome. Endoscopic posterior ankle decompression removing the os trigonum and releasing the PTFL-posterior capsule complex resolves posterior impingement.
PTFL and posterior capsule compression of the os trigonum or prominent posterior talar process in plantarflexion managed with endoscopic posterior ankle decompression.
