MR diagnosis of traumatic tear of the spring ligament in a pole vaulter

Abstract

The spring ligament is a significant contributor to the stability of the talar head and longitudinal arch of the foot, lending importance to accurate radiologic diagnosis of injury. Using MR, we diagnosed a spring ligament tear with associated navicular dorsal subluxation, confirmed intraoperatively. To our knowledge, there are no previous reports of MR diagnosis of tear of the spring ligament.

Spring Ligament Complex: MR Imaging–Anatomic Correlation and Findings in Asymptomatic Subjects

“…The imaging literature on the spring ligament complex is sparse (14,15,23,24). Yao et al reported MR imaging findings in 13 cases of surgically proved spring ligament insufficiency (14).…”

The Spring Ligament Recess of the Talocalcaneonavicular Joint: Depiction on MR Images With Cadaveric and Histologic Correlation

“…The imaging features of spring ligament tears and insufficiency have been well described [3,4]. While tears are best diagnosed by frank discontinuity of the ligament fibers [5,10], the diagnosis of insufficiency is made by signal heterogeneity, attenuation, or thickening of the liga-ment. Acute spring ligament tears are related to trauma as opposed to spring ligament insufficiency, which is the result of gradual ligament attrition and stretching.…”

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Much has been written describing the normal and pathologic MR features of the spring ligament [2][3][4][5][6]. To our knowledge, however, there has not yet been a study reporting the presence and the imaging features of the spring ligament recess, a fluid collection extending from the talocalcaneonavicular joint, interposed between the medioplantar oblique and inferoplantar longitudinal components of the spring ligament.

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Ultrasound assessment of the spring ligament complex

“…The condition is typically seen in middle-aged women and may result in an acquired flatfoot [5]. There is usually no history of trauma, although acute injury of the spring ligament has been reported [19,20]. The pathology is usually confined to the superomedial CNL.…”

“…In one case, the PTT was considered normal. Although spring-ligament dysfunction is classically associated with posterior tibial tendinosis, it is recognised that the spring ligament may be torn in isolation [19,20].…”