Over ones life time, the lower limb receives much trauma just from walking and carrying around the weight of the body. Add to that any athletics and exercise you have done and it is any wonder that we can move when we get to old age. In fact, many people suffer dearly for their earlier actions. One area of the lower limb that receives its share of the trauma is the ankle. The ankle also needs to be as stable as possible. For this reason, I have provided some added detail of the structures that are related to the various sides of the ankle. Except for some of the ligaments around the ankle joint, the stability of the ankle depends on the tendons of very strong muscles that cross the ankle joint.

We will start by looking at the medial side of the ankle and identify the:
    structures passing anterior to the medial malleolus
  • tendon of the tibialis anterior
    structures passing posterior to the medial malleolus (pneumonic:Tom Dick Harry)
  • tibialis posterior (T)
  • flexor digitorum longus (D)
  • flexor hallucis longus (H)
In order for these flexor and extensor tendons to perform their duty properly, they must be kept close to the bones of the ankle. The structures that keep them close are the retinaculae:
  • superior extensor retinaculum
  • flexor retinaculum
  • inferior extensor retinaculum

From the lateral side, you should first identify the tendons of the following muscles passing behind the lateral malleolus:
  • peroneus longus
  • peroneus brevis

Structures passing anterior to the ankle:
  • peroneus tertius (part of the
    extensor digitorum longus)
  • tendons of the extensor digitorum longus
  • tendon of the extensor hallucis longus
From the lateral view, identify the superior and inferior peroneal retinaculae. These keep the tendons of the peroneus longus and brevis close to the lateral malleolus.

Practice Examination

Sole of the Foot   Joints of the Lower Limb

Lower Limb Bones |  Anterior Thigh |  Medial Thigh |  Gluteal Region |  Posterior Thigh |  Anterior Leg and Dorsal Foot |  Lateral Leg |  Posterior Leg |  Sole of the Foot |  Ankle |  Joints of the Lower Limb |  Summary of Items in the Lower Limb | Radiographs of the Lower Limb |  Table of Muscles |