The long plantar ligament is the longest ligament in the foot, supporting the lateral column and forming the tunnel through which the peroneus longus tendon crosses the plantar midfoot to reach the medial cuneiform. Its deep portion reinforces the calcaneocuboid joint (the primary lateral column joint) and its superficial portion creates the peroneus longus tunnel. Attenuation of the long plantar ligament contributes to lateral column instability in progressive flatfoot.
An expanded entry for Long Plantar Ligament.
| Origin | Plantar calcaneus (just anterior to the calcaneal tuberosity) |
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| Insertion | Deep fibres: plantar cuboid. Superficial fibres: bases of the 2nd-5th metatarsals via the fibular (peroneal) tunnel |
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Supports the lateral longitudinal arch and forms the roof of the tunnel for the peroneus longus tendon.
The long plantar ligament is assessed in complete flatfoot evaluation: its attenuation on MRI (signal increase and thickening) and sagging of the cuboid indicate lateral column involvement beyond the typical medial tibialis posterior and spring ligament failure. It can be incorporated in flatfoot reconstruction by direct repair or synthetic augmentation. In lateral column lengthening osteotomy its attachments are preserved to maintain lateral column integrity.
Long plantar ligament attenuation contributing to lateral arch collapse in severe flatfoot managed with lateral column reconstruction.
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