While at-home remedies may help alleviate your symptoms, this improvement may be temporary. Surgeries may also be needed in some cases, including many types of Lisfranc injuries, and infrequently for midfoot arthritis or certain types of stress fractures. There is a small avulsed fragment at the dorsal aspect of the navicular bone, associated with mild swelling of the overlying soft tissue. Physical therapy may also include techniques to reduce pain and swelling. Fig. With an ORIF, your bone fragments are put back in place and held together with a metal plate and/or screws until your bone heals. Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-80197, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":80197,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/dorsal-talonavicular-ligament/questions/2122?lang=us"}. injuries of the proximal interphalangeal joint Midtarsal sprain. information and will only use or disclose that information as set forth in our notice of As their names suggest, the calcaneocuboid part inserts onto the medial aspect of the cuboid, while the calcaneonavicular part inserts onto the lateral aspect of the navicular. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. JOURNAL CLUB: MRI Evaluation of Midtarsal (Chopart) Sprain in the Setting of Acute Ankle Injury. Some conditions that cause pain on the top of the foot can be treated with common at-home remedies. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. Thedorsal talonavicular ligament is one of the three stabilizers of the talonavicular joint and therefore a stabilizer of the midtarsal (Chopart) joint. However, while your mind may immediately go to the worst-case scenario, dorsal foot symptoms can be easily and effectively treated in many situations. Disclaimer. In the transverse tarsal joint, the RoM for adduction/abduction is much less than that of eversion, due to the fact that the long axis of rotation is closer to being longitudinal than vertical. This site needs JavaScript to work properly. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Injections. This content does not have an Arabic version. Calcaneofibular Ligament Injury - StatPearls - NCBI 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://orthoinfo.aaos.org/en/diseases--conditions/talus-fractures), (https://www.footcaremd.org/conditions-treatments/ankle/talus-fracture), (https://ota.org/for-patients/find-info-body-part/3833), (https://www.ncbi.nlm.nih.gov/books/NBK539687/), nonsteroidal anti-inflammatory drugs (NSAIDs). There is a problem with This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 2021 BunionSurgeryMiami.com - Dr. Ray Lopez - All Rights Reserved. With an external fixator, your surgeon will place large pins in your bones to hold them in place. William R. Walter, Anna Hirschmann, Erin F. Alaia, Monica Tafur, Zehava S. Rosenberg. However, some more severe Lisfranc injuries or stress fractures, as well as midfoot arthritis that does not respond to initial treatments, may require surgery. 400 Arthur Godfrey Road Suite #412 Miami Beach, FL 33140. For the transverse tarsal joint, two axes of rotation have been described; a longitudinal axis which likes 15 upwards and anterior to the transverse plane, and 9 medial to the sagittal plane, and an oblique axis which is inclined 52 superior to the transverse plane and 57 medial to the sagittal plane. Paying attention to the details of your condition can help you get to the bottom of the soreness. Results: Talus avulsion fractures Laskowski ER (expert opinion). (1989). 2007 Mar;47(3):216-23. doi: 10.1007/s00117-006-1442-z. To do that; you need to correlate with the clinical complaint and the tenderness location on physical exam. I would honestly say that Kenhub cut my study time in half. Causes of Foot Pain and Treatment Options, Psoriatic Arthritis in Feet: What it Looks Like. Overuse injuries usually occur over time after the volume or intensity of a repetitive activity (like running or jumping) is quickly increased. Midtarsal sprain Inversion-related fractures in midtarsal sprains occur in three main patterns 1: Eversion-related fractures in midtarsal sprains result in two main patterns 1: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Solid white arrow heads show ligament and fine white arrow shows effusion and site of ligamentous injury. The dorsal talonavicular ligament (DTNL) can be considered a localised region of capsular thickening connecting the dorsal aspect of the talar neck and the The calcaneonavicular ligament lesion may be single or related to posterior tibial tendon involvement; the clinical and image-based diagnosis is difficult, without pathognomonic signs. The dorsal talonavicular ligament is one of the three stabilizers of the talonavicular joint and therefore a stabilizer of the midtarsal (Chopart) joint. The dorsal talonavicular ligament extends from the mid-talar neck to the navicular bone and merges with the joint capsule medially and laterally 1,2. However, Drakonaki et al studied 59 patients with ultrasound-guided steroid injections into the midfoot. 2019;39(1):136-52. Language links are at the top of the page across from the title. Case study, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-57647. include protected health information. Orthotics (shoe inserts) may also be used along with Voltaren gel to help alleviate some of the pain. Depending on the complexity of your injury, you may have to wear the cast for eight to 12 weeks or more. Fortunately, there are many things that can be done to help manage the symptoms of this condition. Treatment of an avulsion fracture typically includes resting and icing the affected area, followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. To watch our video tutorial and test your knowledge on all ligaments of the foot, check out this study unit: The innervation of the inferomedial aspect of the talocalcaneonavicular joint is provided by the medial plantar nerve, while the dorsomedial, dorsal and lateral aspects receive branches of thedeep (peroneal) fibular nerve. Continuous line: toe-extended high-arch position. That said, keeping track of your symptoms and when they originated can help you hone in on the potential cause of your condition. Your talus joins with your tibia and fibula (lower leg bones) to form your ankle joint. The Ligaments of the Foot To provide you with the most relevant and helpful information, and understand which If your bone is broken into several pieces, your surgeon may perform an open reduction and internal fixation (ORIF). Supination is a composite movement which combines inversion, adduction and plantarflexion at these joints. Are Nerve Problems Causing Your Foot Pain? WebTreatment for a talus fracture depends on the type of fracture and the severity of your injury. Radiographics. Lateral Ankle Instability Including Chopart Joint | SpringerLink Treatment ranges from a conservative approach, similar to the management of lateral ankle sprains, to more aggressive strategies including longer immobilization, (a) Front/medial view with the naviculointermediate cuneiform ligament intact. American Orthopaedic Foot & Ankle Society. Physical therapy:Range-of-motion and strengthening exercises are beneficial once the lesion is adequately healed. navicular 2022 Oct;51(10):1937-1946. doi: 10.1007/s00256-022-04043-3. J Clin Endocrinol Metab. Check for errors and try again. Helgeson K. (2009). Careers. 21% of the patients had an injury to the TNL. While typically asymptomatic, occasionally the cyst can cause tingling if it presses on a nerve or soreness if it contacts a tendon or joint. Philadelphia, PA: Lippincott Williams & Wilkins. In the subtalar joint, since the axis of rotation is roughly halfway between the vertical and longitudinal orthogonal axes, the range of motion for adduction/abduction is usually similar to that mentioned for inversion/eversion. Due to their simultaneous movement these joints are often considered as one collective functional unit in clinical practice, which is somewhat confusingly referred to as the (functional) subtalar joint. The solid white arrow. Treatment of closed subtalar joint dislocation: A case report and The windlass mechanism and changes in foot shape. This can include extensor tendonitis, where the tendons that help lift the foot and toes become overused and painful, or metatarsal stress fractures, where a small crack gradually develops in one of the bones at the base of your toes. Bullock SA, Allen GM, Watson MS, Wilson DJ. All content published on Kenhub is reviewed by medical and anatomy experts. Walter W, Hirschmann A, Alaia E, Tafur M, Rosenberg Z. Sign & Symptoms: Unless the injury is extensive, it can take up to months, a year, or even longer for symptoms to develop. Usually, a broken piece of the damaged cartilage/bone will float inside the ankle. Navicular Fracture Ultrasound images showing (a) a normal talonavicular ligament (TNL) and (b) a complete tear of the TNL. Gout symptoms should be reported to a healthcare provider immediately to initiate treatment. WebTreating the symptoms of plantar fasciitis can ease pain associated with heel spurs. Due to the orientation of the mentioned axes of rotation for the subtalar and transverse tarsal joints, the RoM for these movements is minor relative to inversion/eversion and abduction/adduction, except in the case of rotation around the oblique axis of the transverse tarsal joint. Oatis, C. A. X-rays are taken, and often an MRI or other advanced imaging tests are ordered to further evaluate the lesion and extent of the injury. Talonavicular ligament of a fresh-frozen cadaver. Episodes of swelling of the ankle when bearing weight and subsiding when at rest. This condition occurs when high levels of uric acid cause a buildup of irritating urate crystals in a joint. Would highly recommend! Acute Fracture of the Anterior Process of Calcaneus: Does It Br J Radiol. Roberto Grujii MD Haematoxylineosin: original magnification 400. Avulsion fracture of the dorsal aspect of the navicular bone usually associated with talonavicular ligament injury. Ringleb SI, Udupa JK, Siegler S, Imhauser CW, Hirsch BE, Liu J, Odhner D, Okereke E, Roach N. J Orthop Res. Following a comprehensive examination, theyll be able to guide your recovery from this sometimes disabling issue. Learn more about the general features of the synovial joints by exploring articles, diagrams, videos and quizzes. General principles of orthopedic injuries. Dorsiflexion and plantarflexion of the subtalar and transverse tarsal joints occur around a mediolateral axis within the sagittal plane. Thedorsal talonavicular ligament is one of the three stabilisers of the talonavicular joint and therefore a stabiliser of the midtarsal (Chopart) joint. Simple illustration of the windlass, Ultrasound image of the talonavicular joint during stress test. Osteoarthritis, Osteophytes, and Enthesophytes Affect Biomechanical Function in Adults With X-linked Hypophosphatemia. For example, gout is a form of inflammatory arthritis that leads to sudden, severe pain in the foot or base of the big toe. Clinically Oriented Anatomy (7th ed.). He made me feel so comfortable and welcoming. Cleveland Clinic is a non-profit academic medical center. government site. The solid white arrow shows the proximal aspect of the cortical bone of the navicular, and the dashed white arrow shows the edge of the cartilage at the level of the dorsal lip of the talar head. Walter W, Hirschmann A, Alaia E, Garwood E, Rosenberg Z. Adam H. Kaplan, DPM, is a podiatrist who has been in private practice for over 5 years in New Jersey and specializes in a wide scope of foot care. The plantar portion of the superomedial part is supported by the tendons of flexors of the foot; tibialis posterior, flexor hallucis longus and flexor digitorum longus muscles. The majority of these injuries can also be treated by closed means, but they require more prolonged immobilization and more commonly result in reduced mobility than volar plate and collateral ligament injuries. Decisions regarding treatment of displaced body fractures, as well as dorsal avulsion fractures involving more than 25% of the talonavicular joint, should be made in consultation with orthopedics. For example, Lisfranc injuries occur when the midfoot joints dislocate after the ligaments in this region are torn. 2. In: Essential Orthopaedics. These movements are affected by several adjacent joints, ligaments and periarticular tendinous tissue. The dorsal talonavicular ligament is a broad, thin band, which connects the neck of the talus to the dorsal surface of the navicular bone; it is covered by the Extensor tendons. Its mostly covered in cartilage. ADVERTISEMENT: Supporters see fewer/no ads. In rare cases, if the bone fragment and main bone are too far apart to fuse naturally, surgery may be necessary to reunite them. Pfenninger JL, et al. All rights reserved. After treatment, many people may return to normal activities after your healthcare provider gives you clearance to do so. Its anatomy suggests resistance to tensile forces and its injury allows excessive movement at the TNJ. You wont be able to put full weight on your foot for a few months. Medially, the anterior fibers of the deltoid ligament add support. An avulsion fracture to your foot or ankle may require a cast or walking boot. 2018 Jan;91(1081):20170213. doi: 10.1259/bjr.20170213. Ligaments of the medial aspect of the foot. Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Arterial supply for the subtalar joint comes from the articular branches of following arteries: Movement at the talocalcaneonavicular joint is complex due to the fact that its talocalcaneal and talonavicular components are considered as belonging to different functional joints. The calcaneonavicular part of this ligament is significant for the talocalcaneonavicular joint since its dorsal surface participates in the formation of the middle part of the acetabulum pedis. Kim Bengochea, Regis University, Denver. Ganglion cyst. (Talonavicular ligament labeled at center top.) Sconfienza L, Orlandi D, Lacelli F, Serafini G, Silvestri E. Dynamic High-Resolution US of Ankle and Midfoot Ligaments: Normal Anatomic Structure and Imaging Technique. The principle that guides treatment is the removal of bending forces or stresses. WebX-ray Lateral There is a small avulsed fragment at the dorsal aspect of the navicular bone, associated with mild swelling of the overlying soft tissue. AJR Am J Roentgenol. These complications include: After surgery, youll experience some pain. At the time the article was created Joachim Feger had no recorded disclosures. Lisfranc (midfoot) injury. Please enable it to take advantage of the complete set of features! With or without surgery, your foot will be in a cast or splint. health information, we will treat all of that information as protected health In the case of the subtalar joint, studies have suggested that the average axis of rotation is orientated 42 upwards and anterior to the transverse plane, and 16 from the sagittal plane. see full revision history and disclosures. 2. Occasional clicking feeling in the ankle when walking, Sensations of the ankle locking or giving out. What is osteochondral repair of talus? HHS Vulnerability Disclosure, Help Once your talus bone is healed, your healthcare provider may recommend rehabilitation or physical therapy to help improve the function of your ankle. 210 (2): 386-395. the unsubscribe link in the e-mail. It runs from proximal lateral to distal medial, being the continuation of the anterior talofibular ligament. Talonavicular ligament: prevalence of injury in ankle Temporarily discontinuing activities that cause flare-ups can help reduce stress and alleviate pain. This fluid-filled prominence develops gradually and can occur in many places, including the top of the foot. (2018) RadioGraphics. Grounded on academic literature and research, validated by experts, and trusted by more than 2 million users. Your talus is the main connection between your foot and your leg. Normal Anatomy and Traumatic Injury of the Midtarsal Unable to process the form. This is called. Conclusion: These include, but are not limited to: Some of these symptoms are unique to a particular diagnosis, while others can be seen with numerous causes of dorsal foot pain. Get useful, helpful and relevant health + wellness information. Fig. Haematoxylineosin: original magnification 400. I had been experiencing foot pain for months, and it was starting to affect my daily life, so I decided to see Dr. Ray. Taking oral anti-inflammatory medicine. Atlas of Human Anatomy (7th ed.). Injury. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. The dorsal talonavicular ligament originates at the dorsal aspect talar neck and inserts at the dorsal surface of the navicular bone3. Kenhub. In the talocalcaneonavicular joint, the two types of movements (gliding and rotation) allow motions in 3 degrees of freedom: inversion/eversion, abduction/adduction, plantarflexion/dorsiflexion. They are located medially and laterally, respectively. Because of this complex nature, it can be difficult to determine the exact cause of pain on the top (dorsal) part of the foot. It can also occur after an auto accident or a fall. The diagnosis is made during surgery and the calcaneonavicular ligament should always be explored whenever the posterior tibial tendon is involved. Displacement at the TNJ after stress with the TNL intact measured 0.18 0.08 cm and 0.29 0.07 cm (p < 0.005) when divided. Copyright The anterior aspect of the acetabulum is formed by the concave proximal articular facet of the navicular bone. Midfoot osteoarthritis, on the other hand, is a more localized version of arthritis. Reliability and validity of different ankle MRI scanning planes for the anterior talofibular ligament injury diagnosis: a cadaveric study. Each patient had undergone ultrasound and cone beam CT examination of the ankle. The thickened talonavicular ligaments reinforce the talonavicular joint in a plantar and dorsal orientation. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Typically, three to six weeks is sufficient. Your talus is a bone in your foot that connects your ankle to your leg. I got foot fillers with Dr. Ray because I wear a lot of high heels and it made everything so much better 10/10 recommend! sharing sensitive information, make sure youre on a federal If youre on your feet all day, you may not be able to return to work for up to a year. Ultrasound images showing (a) a normal talonavicular ligament (TNL) and (b) a complete, Talonavicular ligament (TNL) of an embalmed cadaver. This is referred to as an osteochondral defect (OCD) or osteochondral lesion The hip, elbow and ankle are the most common locations for avulsion fractures in the young athlete. A slight periosteal edema is the first sign of stress fracture which, in the absence of treatment, is followed by BME in the medullary cavity. Epub 2017 Jul 13. de Cesar Netto C, Pinto M, Roberts L, Lee SR, Roney AR, Naranje S, Godoy-Santos AL, Shah A. Become a Gold Supporter and see no third-party ads. 1. Nonsurgical tarsal coalition treatments Rest. First, youll be placed in a splint to keep your foot and ankle from moving. The dorsal talonavicular ligament is a broad, thin band, which connects the neck of the As the name suggests, the talocalcaneonavicular joint is a synovial ball and socket joint formed between three tarsal bones (talus, calcaneus and navicular) and the adjacent ligamentous structures. talonavicular ligament) is a broad band that stretches between the dorsal aspect of the neck of talus and the The windlass mechanism and changes in foot shape. Learn more about the anatomy of the ankle and foot, and cement your knowledge with ourfun quizzes and diagram exercises. Avulsion fracture: How is it treated? - Mayo Clinic Webcalcaneocuboid and talonavicular joints [8, 1012]. All rights reserved. During this period of immobilization, non-weightbearing range-of-motion exercises may be recommended. The dorsal talonavicular ligament (a.k.a. By Tim Petrie, DPT, OCS This injury commonly happens when the foot is in a downward pointed (plantarflexed) position, and someone lands on top of it. A talus fracture is a broken bone in your ankle. Cartilage is a slippery material that allows your bones to move smoothly against each other. Top of the foot pain can be caused by many things, including chronic health conditions and more acute injuries. Bone marrow edema of the medioplantar talar head is associated with severe ligamentous injury in ankle sprain. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. At the time the article was last revised Joachim Feger had no recorded disclosures. Click here for an email preview. Ask you to move your toes, checking for nerve damage. Dealing with pain on the top of the foot, especially if it appears suddenly or is intense, can be an unnerving experience. This same treatment is also commonly needed for metatarsal stress fractures, along with using crutches to avoid weight-bearing through the injured area. These injuries include car and motorcycle accidents and falls from significant heights. A talus fracture can cause significant loss of function in your ankle. Epub 2019 Dec 4. The site is secure. (a) Front/medial view with the naviculointermediate cuneiform, Dense connective tissue in talonavicular, Dense connective tissue in talonavicular ligament composed of collagen bundles with a parallel, Area of talonavicular ligament insertion, Area of talonavicular ligament insertion into bone (*) in which there are osteocyte, MeSH Extremity CT and ultrasound in the assessment of ankle injuries: occult fractures and ligament injuries. This can affect your ability to walk and bear weight on your foot. Soft-tissue edema along the dorsal aspect of the foot and talar contusions further confound On ultrasound, the dorsal talonavicular can be best pictured longitudinally with the probe positioned on the superolateral midfoot 3. Histological examination demonstrated a dense connective tissue composed of bundles of collagen in parallel arrangement along the ligament length. Extensor tendinopathy. Cael, C. (2010). Examine you for other injuries, depending on the cause of your injury. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. Simple illustration of the windlass mechanism and tracing from radiographs of a living foot, standing. For example, avulsion fractures of the dorsal talonavicular ligament will often be concomitant with avulsion fracture of the anterior process of the calcaneus and plantar talar head impaction ( Figs 7, 11 ). Arrow demonstrates the naviculointermediate cuneiform ligament. Non-stress fractures of the tarsal (foot) navicular - UpToDate Talus fractures usually occur due to high-impact injuries such as car accidents. Midtarsal sprains are common injuries of the foot but are often under-recognized both clinically and radiologically. Walter W, Hirschmann A, Alaia E, Tafur M, Rosenberg Z. Talus fractures usually require surgery to repair. If your fracture is stable and your joints are well-aligned, surgery may not be necessary. Follow up images after 14 In children, avulsion fractures that involve the growth plates also might require surgery. 2020 Jan;93(1105):20180989. doi: 10.1259/bjr.20180989. Philadelphia, Pa.: Mosby Elsevier; 2011. https://www.clinicalkey.com. WebTarsal coalition can be treated with surgical or nonsurgical methods, depending on the severity of the condition. Your talus sits above your heel bone (calcaneus), forming your subtalar joint. Advances in knowledge: Injury to the TNL is common and has not Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Bookshelf Netter, F. (2019). and grab your free ultimate anatomy study guide! 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Unable to process the form. This content does not have an English version. WebThe talonavicular ligament is often thickened on MRI for reasons unrelated to Chopart joint injury, such as traction and altered biomechanics. Sometimes, talus fractures occur due to twisting your ankle, which can result in small chips breaking off the edges of your talus. Restriction of activity. Amazing experience with Dr. ray! Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Reading time: 14 minutes. Marx JA, et al., eds. The dorsal talonavicular ligament and the anterior tibiotalar ligament insert onto the extra articular dorsal surface of the talus 96 of them involved an osseous injury, 0.5% of these were dorsal talus avulsion fractures and 0.5% were navicular avulsion fractures. 3. Depending on the severity of your injury and the type of job you have, you may not be able to return to work right away. There are three principal ligaments associated with this joint: the dorsal talonavicular ligament, plantar calcaneonavicular ligament and calcaneocuboid part of the bifurcate ligament. An avulsion fracture occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone. Top of Foot Pain (Dorsal Foot Pain) - Verywell Health You may need to spend a few weeks on crutches if you have an avulsion fracture around your hip. Would you like email updates of new search results? Epub 2017 Nov 9. Depending on the origins of your dorsal foot pain, several other corresponding symptoms may also be present in this area. It depends on the type of talus fracture you have. Anatomy and human movement: structure and function (6th ed.). also, as in our case, the associated swelling of the overlying soft tissue, as well as the fact that the aspect of the avulsed fragment facing the navicular bone is not well-corticated support the diagnosis of an avulsion fracture rather than os supranviculare. If we combine this information with your protected What Is Sinus Tarsi Syndrome dorsal talar head +/- dorsal navicular: dorsal talonavicular ligament Eversion-related fractures in midtarsal sprains result in two main patterns 1: medial column distraction injuries navicular tuberosity: tibialis posterior avulsion / superomedial spring ligament lateral column impaction fractures calcaneocuboid joint impaction fractures In many cases, injuries that affect the midfoot can be managed conservatively with activity modification, physical therapy, or pain medication. The dorsal talonavicular ligament originates at the dorsal aspect talar neck and inserts at the dorsal surface of the navicular bone3. and transmitted securely. {"url":"/signup-modal-props.json?lang=us"}, Feger J, Dorsal talonavicular ligament. Acknowledgments to Wiley Editors for the use of the tracings taken from Hicks with permission from Wiley. Federal government websites often end in .gov or .mil. This ligament is located inferior to tendons of muscles that extend the foot.

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