Anatomical Study of the Cervical and Interosseous Talocalcaneal Ligaments of the Foot with Surgical Relevance

Abstract

There is conflicting evidence regarding the morphology and orientation of the cervical ligament (CL) and interosseous talocalcaneal ligament (ITCL). The morphology of the CL and its relationship to the ITCL were studied to obtain an understanding of these structures. Twenty-six feet (13 left, 13 right) were obtained from formalin-fixed cadavers (14 females, four males) with the mean standard deviation (SD) age at death 80.9 (12.9) years. All measurements were made with a digital caliper. The length and width of the foot, the width and height of the talus, were measured. The talus was cut coronally to expose the ITCL and qualitative observations were noted. The mean (SD) heights and widths of the CL at the anterior, posterior, superior, and inferior points were 8.27 (2.52), 13.95 (5.96), 9.15 (2.45), and 11.90 (4.30) mm, respectively. The mean (SD) thicknesses of the CL at the superoanterior, superoposterior, inferoanterior, inferoposterior, and central points were 0.62 (0.24), 1.05 (0.30), 0.70 (0.26), 1.20 (0.34), and 0.97 (0.31) mm, respectively. The fibers of the CL are oriented at a slight superoanterior to inferoposterior angle, whereas the fibers of the ITCL are oriented in a slight superomedial to inferolateral angle. The fibers of the CL and ITCL overlap inside the tarsal sinus with the CL positioned anteriorly, which helps to distinguish the two ligaments. In this study, we identified the morphometrics of the CL and described the CL and ITCL qualitatively. These results are relevant to introducing innovative techniques for reconstructive surgery of the subtalar ligaments in order to repair, for example, subtalar instability.