Surgical and Radiologic Anatomy

, Volume 41, Issue 12, pp 1441–1443 | Cite as

Morphological features of the posterior intermalleolar ligament

  • Mutsuaki EdamaEmail author
  • T. Takabayashi
  • T. Inai
  • R. Hirabayashi
  • M. Ikezu
  • F. Kaneko
  • M. Kanta
  • I. Kageyama
Anatomic Variations



In the present study, the posterior intermalleolar ligament (PIML) was classified by type using large-scale cadavers to provide basic information to help elucidate the mechanism of ankle joint posterior impingement syndrome.


This investigation examined 100 legs from 49 Japanese cadavers (mean age at death, 79 ± 11 years; 58 sides from men, 42 from women). In the classification method, an absent PIML was classified as Type I, a PIML with one fiber bundle (attachment to one place) was Type II, a PIML with two fiber bundles (attachment to two places) was Type III, and a PIML with three fiber bundles (attachment to three or more places) was Type IV. Furthermore, according to other adhering tissues, they were further subdivided and classified by type.


There were various types of PIML: 19 (19%) Type I; 24 (24%) Type II; 23 (23%) Type III; and 34 (34%) Type IV. A PIML was present in 81 legs (81%). There were no significant differences between men and women and between left and right sides.


The complex relationships of the PIML with the surrounding ligaments and tissues are considered to be among the factors that make interpretation of imaging findings difficult.


Posterior impingement syndrome Gross anatomy Large-scale cadavers 



The authors would like to acknowledge and thank those anonymous individuals who generously donated their bodies so that this study could be performed. This study was supported by a Grant-in-Aid for Scientific Research (19K11358) from the Japan Society for the Promotion of Science (JSPS) and a Grant-in-Aid program from Niigata University of Health and Welfare (H30B05).

Author contributions

ME and TT contributed to study design and data collection, and drafted the manuscript; TI contributed to data analysis and made critical revisions to the manuscript; RH, MI, FK, and KM made critical revisions to the manuscript; IK supervised the study, contributed to analysis and interpretation of data, and made critical revisions to the manuscript. All authors read and approved the final manuscript prior to submission.



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The methods were carried out in accordance with the 1964 Declaration of Helsinki, and the cadavers were legally donated for the research by the Nippon Dental University of Life Dentistry at Niigata in Japan.

Informed consent

Informed consent was obtained from the families of all subjects.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute for Human Movement and Medical SciencesNiigata University of Health and WelfareNiigataJapan
  2. 2.Department of Anatomy, School of Life Dentistry at NiigataNippon Dental UniversityNiigataJapan

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