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ATF Reconstruction

General Information

ATF stands for anterior talofibular. The anterior or front talofibular ligament is located in the ankle joint and is commonly sprained or injured. The ligament is considered on the of the smallest and weakest in the ankle joint at the conjunction of the two lower leg bones - the tibia and the fibula, and the talus bone in the ankle, the large bone that connects the tibia and fibula to the foot.

Reasons for ATF Reconstruction

  • Chronic sprained ankle
  • Lack of weightbearing capability
  • Limited range of motion
  • Reduced ankle stability


  • X-rays
  • MRI
  • Categorization of level of injury
  • Grade 1 - injury without tears
  • Grade 2 - partial tearing
  • Grade 3 - complete tearing


You may require surgical reconstruction of the ATF ligament if it has been completely torn and non-surgical methods don't help restore weight bearing or range of motion of the ankle. In most cases, surgery may be recommended in cases of chronic or ongoing mechanical instability of the ankle joint. Surgery is performed through an arthroscopic technique.

  • The surgeon removes portions of the damaged ligament
  • The surgeon may opt to suture the torn lament and reinsert it into the bone, sometimes attaching portions of the ligament to surrounding structures for greater strength and stability
  • The surgeon may opt to use and replace a portion of or the entire ligament with a portion of ligament from another part of the body in order to reconstruct the torn or damaged ligament
  • Following suturing or reattachment, the incisions are closed and the ankle bandaged

What to Expect

The length of the reconstruction surgery depends on the approach used by the surgeon, as well as the severity of damage to the ATF ligament. The procedure may take 1 to 2 hours. Any surgery involving ankle reconstruction or replacement of damaged areas may require a cast or a brace. You may be on crutches and on a non-weightbearing status. Once the cast or brace is removed, partial and full weight-bearing activities and range of motion exercise to encourage healing and maintain ankle joint function.