Seven patients who had pain in the anterior aspect of the ankle were
found to have a thickened distal fascicle of the anteroinferior
tibiofibular ligament. Each patient had a history of an inversion sprain of
the ankle followed by chronic pain in the anterior aspect of the ankle. The
thickened distal fascicle was resected without loss of stability of the
ankle. Five patients needed debridement of an area of abraded hyaline
cartilage on the anterolateral aspect of the talus. Six patients were
followed for a mean of thirty-nine months (range, twenty-four to fifty-nine
months). Four of them had no pain in the ankle or limitation in activities,
and two reported marked improvement, with only occasional pain in the ankle
related to overuse. A separate distal fascicle of the anteroinferior
tibiofibular ligament is present in most human ankles and can be a cause of
talar impingement, abrasion of the articular cartilage, and pain in the
anterior aspect of the ankle. Resection of this ligament usually will
alleviate the pain caused by the impingement.