Spring Ligament Repair

⚙️What This Procedure Involves

An incision is made on the inner side of the foot. The attenuated or torn spring ligament is identified. Direct repair with strong sutures may be possible if tissue quality allows. More commonly, the ligament is augmented or reconstructed using an internal brace (suture tape reinforcement), a peroneus longus tendon graft, or allograft tissue. This is almost always combined with other procedures: flexor digitorum longus tendon transfer, calcaneal osteotomy, and possibly lateral column lengthening. The spring ligament repair adds 30–45 minutes to the overall procedure.

💡Why It May Be Recommended

The spring ligament is a key static stabiliser of the talonavicular joint and medial arch. When it fails, the arch collapses regardless of other repairs. Addressing the spring ligament during flatfoot reconstruction improves outcomes and reduces recurrence.

⚖️Non-Operative Alternatives

Custom orthotics, ankle-foot orthosis, and supportive footwear. These manage symptoms but cannot restore a torn spring ligament.

📋Preparing for Surgery

MRI showing spring ligament attenuation or tear. Weight-bearing X-rays showing talonavicular uncoverage. Part of comprehensive flatfoot reconstruction planning.

✅Expected Benefits

Restoration of static medial arch support, improving the durability of the overall flatfoot reconstruction. Reduces the risk of arch collapse recurrence.

⚠️Common Risks

• Prolonged recoveryExpected

  Part of a larger reconstruction with non-weight-bearing for six to eight weeks.

• SwellingExpected

  Medial ankle and foot swelling.

🔴Less Common but Serious Risks

• Repair failureUncommon

  The reconstructed ligament may stretch or fail.

• Tibial nerve injuryUncommon

  The posterior tibial nerve and its branches are close to the surgical field.

• Wound healingUncommon

  Medial foot incisions can be slow to heal.

• RecurrenceUncommon

  Arch collapse may recur despite repair.

💉Anaesthetic Considerations

General or spinal anaesthesia with ankle block.

🏃Recovery and Rehabilitation

Non-weight-bearing for six to eight weeks. Boot for four to six weeks. Physiotherapy. Custom orthotics long-term. Full recovery nine to twelve months.

📅Follow-Up

X-rays at six weeks and three months.

❓Frequently Asked Questions