The anterior inferior tibiofibular ligament runs from the anterior tibial Chaput tubercle to the anterior fibular Wagstaffe tubercle — the primary anterior syndesmotic component.
Primary anterior syndesmotic stabiliser resisting external rotation and lateral fibular displacement — the most commonly injured syndesmotic structure in high ankle sprains.
First syndesmotic ligament injured in external rotation. Squeeze test and external rotation stress test assess integrity. Fleck sign at Chaput or Wagstaffe tubercle indicates avulsion fracture.
Anterior inferior tibiofibular ligament disruption producing syndesmotic instability and prolonged recovery, managed by protected weight-bearing or screw/TightRope fixation.
Tibial or fibular avulsion at the AITFL attachment requiring fixation when displaced.
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