The cervical ligament is the strongest and most consistent of the sinus tarsi ligaments, running from the talar neck (dorsal surface) obliquely to the calcaneal floor of the sinus tarsi, resisting subtalar inversion and internal calcaneal rotation.
The primary sinus tarsi stabiliser against inversion — resists calcaneal inversion under the talus, prevents subtalar dislocation, and is the first structure to tear in severe inversion injuries involving the subtalar joint.
The cervical ligament is the reference structure in sinus tarsi surgery — its disruption is the primary finding in traumatic sinus tarsi syndrome. Chronic cervical ligament insufficiency produces symptomatic subtalar instability. Reconstruction using a portion of the extensor digitorum brevis has been described.
Cervical ligament disruption producing symptomatic subtalar instability with lateral hindfoot pain on uneven terrain, managed conservatively or by sinus tarsi ligament reconstruction.
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