Anatomical Reflections When Considering Tunnel Placement for Ankle Ligament Reconstruction

The evolution towards more anatomical procedures to restore normal joint mechanics increases the need for detailed knowledge of normal anatomy, possible variations and the position of the ligamentous attachments related to local landmarks. In this chapter we describe the position of the normal anatomical footprints of the ATFL and CFL. Guidelines are offered to locate these points during surgery. The possible tunnels used for reconstruction of ATFL and CFL are presented. Recommendations are given to choose the optimal tunnel position with respect to biomechanics and safety.