The long plantar ligament is the longest tarsal ligament, running from the calcaneal tuberosity and anterior calcaneal surface to the cuboid ridge and the bases of the second through fifth metatarsals, providing the primary lateral column plantar support.
Primary static support of the lateral longitudinal arch, resists cuboid dorsal displacement during push-off, contributes to the plantar tension band of the foot, and forms a tunnel over the peroneus longus tendon in its plantar passage.
Long plantar ligament laxity contributes to lateral column collapse in severe flatfoot deformity, allowing cuboid dorsiflexion. Its assessment is part of comprehensive flatfoot evaluation. In lateral column lengthening osteotomy, the long plantar ligament attachments are preserved to maintain lateral column integrity.
Lateral column sag and cuboid dorsiflexion in severe flatfoot indicates long plantar ligament insufficiency, requiring lateral column lengthening osteotomy and ligamentous reconstruction.
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