Ligaments of the Foot and Ankle

This article is a stub.

The ligaments that surround the ankle act to limit plantarflexion and dorsiflexion, anterior and posterior movement of the foot, tilting of the talus, and inversion and eversion. Each of the different lateral ligaments have different roles in ankle stabilisation that depends on the position of the foot. Ankle stability depends on ligament orientation, loading type, and ankle position at the point of stress. The lateral ankle is more susceptible to injury.

Overview

Ligaments of the foot and ankle

Ligament	Insertion	Action
Anterior talofibular	Lateral malleolus TO neck of talus	Limits anterior displacement of foot or talar
Anterior talotibial	Anterior margin of tibia TO front margin on talus	Limits plantarflexion and abduction of foot
Calcaneocuboid	Calcaneus TO cuboid on dorsal surface	Limits inversion of foot
Calcaneofibular	Lateral malleolus TO tubercle on outer calcaneus	Resists backward displacement of foot; resists inversion
Deltoid	Medial malleolus TO talus, navicular, calcaneus	Resists valgus forces to ankle; limits plantarflexion, dorsiflexion, eversion, abduction of foot
Dorsal (tarsometatarsal)	Tarsals TO metatarsals	Supports arch; maintains relationship between tarsals and metatarsal
Dorsal calcaneocuboid	Calcaneus TO cuboid on dorsal side	Limits inversion
Dorsal talonavicular	Neck of talus TO superior surface of navicular	Supports talonavicular joint; limits inversion
Interosseous (intertarsal)	Connects adjacent tarsals	Supports arch of foot, intertarsal joints
Interosseous (talocalcaneal)	Undersurface of talus TO upper surface of calcaneus	Limits pronation, supination, abduction, adduction, dorsiflexion, plantarflexion
Plantar calcaneocuboid	Undersurface of calcaneus TO undersurface of cuboid	Supports arch
Plantar calcaneonavicular (spring)	Anterior margin of calcaneus TO undersurface on navicular	Supports arch; limits abduction
Posterior talofibular	Inner, back lateral malleolus TO posterior surface of talus	Limits plantarflexion, dorsiflexion, inversion; supports lateral ankle
Posterior talotibial	Tibial TO talus behind articulating facet	Limits planatarflexion; supports medial ankle
Talocalcaneal	Connecting anterior/posterior, medial, lateral talus TO calcaneus	Supports subtalar joint

Deltoid Ligament

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  Deltoid superficial layer

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  Deltoid deep layer

Spring Ligament

Spring ligament complex

The spring (plantar calcaneonavicular) ligament complex is a group of ligaments that connect the calcaneum and navicular and support the talus.

The ligaments include:

• superomedial ligament
  • forms a sling, suspending/articulating against the head of the talus
  • origin from anterior sustentaculum tali with a wide insertion onto the navicular
  • merges with the inferior aspect of the tibial spring ligament (a portion of the superficial deltoid ligament), as best appreciated on coronal views
  • strongest and most important longitudinal arch stabiliser; also most commonly torn/repaired
• medioplantar oblique ligament
  • also known as the lateral calcaneonavicular ligament
• inferoplantar longitudinal ligament
  • also known as the intermedial calcaneonavicular ligament
  • minor role in stabilising hindfoot and longitudinal arch

These ligaments act as the primary static stabilisers of the medial arch of the foot and, together with the posterior tibialis tendon (primary dynamic stabiliser), help support normal hindfoot relations. Failure of these stabilisers leads to hindfoot valgus and pes planus (pes planovalgus)