Review the ultrasound and MR imaging anatomy and pathology of the spring ligament complex and adjacent medial supporting structures. Discuss the current concepts and imaging findings in adult acquired flatfoot deformity (AAFD).

The spring ligament complex (SLC), and adjacent medial supporting structures, namely, the deltoid ligament complex and posterior tibial tendon (PTT) play a key role in the maintenance and stabilisation of the hindfoot and longitudinal arch of the foot. Injury or pathology to one or more of these static and dynamic stabilisers results in instability and AAFD with resultant pes planus and hindfoot valgus. A detailed knowledge and understanding of the normal anatomy, biomechanics and injury patterns of the SLC and medial supporting structures is key...

Normal Imaging Anatomy The spring ligament or plantar calcaneonavicular ligament directly connects the calcaneus to the navicular and functions as the primary static stabiliser of the medial longitudinal arch of the foot. It comprises a group of 3 ligaments that extend between the sustentaculum talus of the calcaneus and the plantar aspect of the navicular and is responsible for supporting the head of the talus in its sling-like configuration. The 3 components of the spring ligament: Superomedial Calcaneonavicular Ligament Medioplantar Oblique Calcaneonavicular Ligament Inferoplantar Longitudinal...

The spring ligament complex is an important static stabiliser of the hindfoot and longitudinal arch of the foot and along with the dynamic stabiliser of the PTTand medial supporting structures, prevents the development of pes planovalgus and the secondary morbidity that results from AAFD. Repair of posterior tibial tendon pathology in isolation, without addressing any co-existent spring ligament complex deficiency may result in poor long-term functional outcome.

G. M. Pillay; Durban/ZA - nothing to disclose

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