Ligament structures in the tarsal sinus and canal

Area of Science:

• Anatomy
• Biomechanics
• Orthopedics

Background:

• Subtalar ligament anatomy and function are debated, potentially hindering clinical ligament reconstruction.
• Accurate anatomical understanding is crucial for effective subtalar joint stability restoration.

Purpose of the Study:

• To precisely describe the anatomy and relationships of the subtalar ligaments, including the inferior extensor retinaculum (IER).
• To clarify the ligamentous structures within the tarsal sinus and tarsal canal.
• To provide a foundation for improved clinical subtalar stability restoration.

Main Methods:

• Dissection and detailed photographic documentation of 32 fresh-frozen cadaver feet.
• Measurement of the inferior extensor retinaculum (IER) and associated subtalar ligaments.
• Examination from both the tarsal sinus portal and a posterior view.

Main Results:

• The inferior extensor retinaculum (IER) has three roots (lateral, intermediate, medial) inserting into the tarsal sinus and canal, dividing the space.
• The cervical ligament (CL) is the primary ligament in the tarsal sinus.
• The interosseous talocalcaneal ligament (ITCL) is a thin band, with the medial root of the IER being the main structure in the tarsal canal.

Conclusions:

• The cervical ligament (CL) is the primary ligament within the tarsal sinus.
• The interosseous talocalcaneal ligament (ITCL) is not a strong bilaminar structure; the medial root of the inferior extensor retinaculum (IER) is the main ligament in the tarsal canal.
• This detailed anatomical description offers a more accurate basis for clinical subtalar stability restoration.