Biomechanical evaluation of longitudinal arch stability

In spite of the common occurrence of pes planus and multiple operations that have been reported to relieve the associated symptoms, there is little published on the relative contribution of various structures to stabilization of the arch of the foot. Twelve fresh-frozen human cadaveric feet were loaded along the tibial axis with compressive loads of 230, 460, and 690 newtons with the specimens intact and after sequential sectioning of plantar fascia, plantar ligaments, and spring ligament. Structures were sectioned in six different sequences and changes in vertical and horizontal dimensions of the medial arch were measured. The highest relative contribution to arch stability was provided by the plantar fascia, followed by plantar ligaments and spring ligament. Plantar fascia was a major factor in maintenance of the medial longitudinal arch. Its division in the cadaveric feet decreased arch stiffness by 25%.