Ligament Insufficiency with Flatfoot Spring Ligament and Deltoid Ligament

Tibiocalcaneonavicular ligament (spring ligament) tears are common in AAFD. Recent studies suggest that the spring ligament may play a role in peritalar medial stability and given its essential role in providing medial tibiotalar and talonavicular stability in advanced AAFD, these ligaments may collectively become attenuated and lead to instability. Both the spring ligament and superficial deltoid ligament work together to stabilize the medial ankle and foot. Surgical repair of both the spring ligament and the deltoid ligament is important for excellent postoperative outcomes in flatfoot reconstruction.