Publication: Implicación de la lesión del complejo ligamentoso de spring en la deformidad del pie plano adulto adquirido
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2019-05-08
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La deformidad del pie plano adulto adquirido ha sido aceptada desde años atrás por los autores como un fallo o lesión del tendón del tibial posterior. Pero la realidad es que, para que esta deformidad se dé, es necesario evaluar la implicación de otras estructuras osteoarticulares y ligamentosas que podrían ser también causantes, como puede ser el complejo ligamentoso de Spring. Este complejo ligamentoso une al calcáneo con el escafoides y biomecánicamente, su función principal es dotar de estabilidad al retropié, siendo el principal elemento de sostén de la articulación talonavicular. De manera secundaria a la fascia plantar, evita el colapso del arco. La importancia de la lesión de esta estructura ha sido comprobada, concluyendo con que el complejo ligamentoso de Spring podría considerarse como de igual importancia diagnóstica al tendón del tibial posterior a la hora de evaluar un pie plano adulto adquirido. Las imágenes obtenidas en resonancia magnética han mostrado hallazgos de lesión del ligamento de Spring compatibles con hallazgos quirúrgicos realizados posteriormente, y con los mostrados en radiografía para la deformidad de pie plano. Por esta razón la resonancia magnética es una prueba diagnóstica clínica fiable para la detección de anormalidades del complejo.
Adult acquired flatfoot deformity has been accepted since years ago by many authors to be a posterior tibialis tendon failure or tear. But the reality is that for the development of the deformity is necessary to evaluate different other osteoarticular and ligament structures that would be the guilty like the Spring ligament complex. This complex attaches the calcaneus and the navicular bones and biomechanically its primary function is giving stability to the hindfoot and being the main support element of the talonavicular joint. In a secondary way to the plantar fascia, it avoids the medial longitudinal arch collapse. The importance of the complex tear has been verified, concluding that the Spring ligament complex could be considered of equally diagnostic importance to the posterior tibialis tendon during the adult acquired flatfoot evaluation. The images obtained in magnetic resonance has shown spring ligament tear findings which fit with those obtained later in surgery, and with those found in the radiological studies. For that reason, magnetic resonance is a reliable clinical diagnostic test for the detection of complex abnormalities.
Adult acquired flatfoot deformity has been accepted since years ago by many authors to be a posterior tibialis tendon failure or tear. But the reality is that for the development of the deformity is necessary to evaluate different other osteoarticular and ligament structures that would be the guilty like the Spring ligament complex. This complex attaches the calcaneus and the navicular bones and biomechanically its primary function is giving stability to the hindfoot and being the main support element of the talonavicular joint. In a secondary way to the plantar fascia, it avoids the medial longitudinal arch collapse. The importance of the complex tear has been verified, concluding that the Spring ligament complex could be considered of equally diagnostic importance to the posterior tibialis tendon during the adult acquired flatfoot evaluation. The images obtained in magnetic resonance has shown spring ligament tear findings which fit with those obtained later in surgery, and with those found in the radiological studies. For that reason, magnetic resonance is a reliable clinical diagnostic test for the detection of complex abnormalities.
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