The cervical ligament is a strong intertarsal ligament running from the cervical tubercle of the talus (anterior to the posterior facet) to the dorsal calcaneus, occupying the anterior sinus tarsi space alongside the interosseous talocalcaneal ligament. It is the primary restraint to subtalar supination and inversion and is the most commonly injured ligament in severe lateral ankle sprains.
Primary restraint to subtalar inversion and supination, stabilising the anterior sinus tarsi compartment and limiting talocalcaneal rotation independent of the interosseous ligament.
Cervical ligament rupture in severe lateral ankle sprain produces sinus tarsi syndrome with lateral hindfoot pain and tenderness over the sinus tarsi opening (anterior to the fibular tip). The pain is reproduced by ankle inversion and is characteristically burning and diffuse rather than the focal anterior fibular ligament pain of ATFL sprains. MRI demonstrates sinus tarsi fluid and ligament disruption. Sinus tarsi block provides diagnostic confirmation and therapeutic benefit. Persistent sinus tarsi syndrome from cervical ligament instability may require arthroscopic debridement or subtalar arthrodesis.
Rupture of the cervical ligament in severe lateral ankle sprain produces sinus tarsi syndrome with chronic anterolateral hindfoot pain and subtalar instability; the sinus tarsi block with local anaesthetic confirms the diagnosis by temporarily abolishing the pain, and treatment ranges from rehabilitation and orthotics to arthroscopic debridement.
