Posterior Ankle Capsule

capsula articulationis talocruralis posterior

The posterior ankle capsule is the posterior fibrous reinforcement of the ankle joint between the posterior distal tibia and the posterior talar dome. It is reinforced by the posterior tibiofibular ligament (transverse tibiofibular ligament) and the posterior talofibular ligament laterally and the posterior tibiotalar component of the deep deltoid medially. The posterior capsule forms the anterior wall of the posterior ankle recess, traversed by the flexor hallucis longus tendon in its groove.

Anatomical Data

Boundaries & Contents

Location	Back of the ankle (talocrural) joint
Boundaries	Attached above to the posterior margin of the tibial articular surface and the inferior transverse tibiofibular ligament Attached below to the posterior margin of the talar trochlea and the posterior process of the talus Thin, reinforced laterally by the posterior talofibular ligament and medially by the deep deltoid fibres
Contents	Posterior recess of the ankle joint cavity Synovial membrane and synovial fluid

Biomechanics

Function & Actions

Closes the back of the ankle joint. It is thin and loose so that it does not block plantarflexion and dorsiflexion.

Clinical Relevance

Clinical Notes

The posterior ankle capsule is a key structure in posterior ankle impingement syndrome, where the capsule and synovium are compressed between the posterior tibia, talus, and os trigonum during forced plantarflexion in ballet dancers and footballers. Posterior ankle arthroscopy, performed prone through posteromedial and posterolateral portals, addresses posterior capsular synovitis and allows os trigonum excision. In total ankle replacement, the posterior capsule is released to achieve adequate ankle joint distraction for component insertion.

Pathology

Common Injuries & Conditions

Posterior Ankle Capsule Impingement

Repetitive forced plantarflexion in dancers and soccer players pinches the posterior ankle capsule and synovium between the posterior tibial lip and the superior calcaneus, producing posterior ankle pain at maximal plantarflexion managed by physiotherapy, corticosteroid injection, or arthroscopic posterior ankle debridement.

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