Plantar Calcaneonavicular Ligament, Medial View

Description

Medial hindfoot anatomy is centered on the plantar calcaneonavicular ligament (spring ligament) spanning from the sustentaculum tali of the calcaneus to the plantar surface of the navicular. Deep to the talar head, its fibrocartilaginous fibers form part of the socket that supports the talus, lying inferior to the talonavicular joint and anterior to the calcaneal tuberosity. Superiorly the talus articulates with the tibia at the tibiotalar joint, while the navicular sits distal to the talar head and proximal to the cuneiforms, with the cuboid and metatarsals extending farther anteriorly into the midfoot and forefoot. Small structure, big consequence. Clinically, this medial perspective is the clearest way to understand how spring ligament integrity stabilizes the talar head and helps preserve the medial longitudinal arch during stance and push-off. Attenuation or rupture, often in the setting of posterior tibial tendon dysfunction, permits plantarflexion and medial rotation of the talus with progressive hindfoot valgus and acquired flatfoot deformity, a pattern that aligns with pain and swelling along the medial foot. Surgeons addressing adult acquired flatfoot frequently evaluate and reconstruct the spring ligament during procedures such as medializing calcaneal osteotomy, lateral column lengthening, and tendon transfer, and this relationship is easiest to teach when the talus, calcaneus, and navicular are oriented in true medial profile. Use this illustration in gross anatomy teaching of the talonavicular and subtalar regions, in orthopaedic and podiatric lectures on progressive collapsing foot deformity, or in surgical atlases discussing spring ligament repair and associated osteotomies. It also supports radiology education when correlating medial column alignment on weight-bearing radiographs and MRI assessment of spring ligament fiber discontinuity beneath the talar head. Anatomical accuracy verified by SciePro's Medical Advisory Board.