anterior talofibular ligament

Right.

The structure that takes the brunt of that force is the anterior talofibular ligament, the ATFL.

Spot on.

It is the most commonly sprained ligament in the entire human body because of that exact vulnerability in the joint’s design.

So when you look down actually with the scope, you can get it in.

If you look down at the distal tip of the fibula, you can actually see where the ATFL is there, is attaching.

And so everything just above that on the interior face of the fibula.

So you just peel that off or you try to resect? I first take the shaver in, I

I want to check for subtle syndesmotic instability because I don't want to miss that as part of their pain syndrome.

So I think it's a huge advantage to do that.

And while they're in there, I mean, and then I just do a curvilinear incision about an inch and a half to two inches long over top of the ATF, between the ATFL and the CFL.

And I just peel the typical, you know, gross room that's augmented and so forth.

How does your thinking with regards to, to managing a ligament like the ACL differ to a ligament like I tore, s- the, the CFL at the, at the ankle?

It depends on what the functionality of the joint is gonna be without that structure or with that structure in a stretched state, right? Ankle sprains and tears of the ATFL or CFL tend to be well-tolerated, you know.

Yes, they hurt.

You gotta go through a lot of rehab, but you generally remain stable and functional after one or two major sprains.

And so the knee is a lot more sensitive to the absence of the ACL than the ankle is to the loss of the CFL.

And in terms of coming back and healing, let's say someone has an ankle sprain like I did, and they tear the ATFL either in isolation or with the CFL.

For me, it was CFL in isolation, which I think is a little rarer, a little more unusual.

I was, like, in a very, a position of dorsiflexion when that occurred.

... um, there's three main ligaments supporting that side of the joint.

The ATFL, that front one, it's the most commonly ruptured one, so you can pull that, and it can essentially snap.

But you can function quite well without it if you are nice and strong, and you have what we call proprioception, so good awareness of your foot position and control with it.

And what's the definition of a sprain? Is that where you've torn a ligament?

And those are?

The anterior talofibular ligament, which we refer to as the ATFL.

the calcaneofibular ligament, the CFL, and the posterior telofibular ligament, the PTFL.

Okay, so ATFL, CFL, and PTFL.

And the data shows that the ATFL is the absolute prime suspect here.

It is.

Approximately 70% of all lateral ankle sprains involve an isolated injury to just the ATFL.

70%.

Love to say I learned my lesson.

On two ruptured ATFL ligaments came third place.

And again, it just further celebrates the survival mechanism of this guy can overcome pain no matter what.

Both his ankles blown up.