The superomedial calcaneonavicular band is the largest spring ligament component, running from the sustentaculum tali to the superomedial navicular. It supports the talar head medially and inferiorly.
Primary talar head support structure preventing medial talar head descent and medial arch collapse. Acts with tibialis posterior and deltoid to maintain the medial longitudinal arch.
Tears first in adult acquired flatfoot. Its failure allows talar head plantar-medial translation producing the "too many toes" sign and arch collapse. Spring ligament reconstruction targeting this band is the key component of flatfoot correction.
Primary failure producing talar head descent and medial arch collapse, requiring reconstruction alongside FDL transfer and calcaneal osteotomy.
Suture tape augmentation, native tissue plication, or allograft reconstruction of the superomedial band to restore talar head support in PCFD.
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