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# Talocalcaneal interosseous ligament

The talocalcaneal interosseous ligament is a strong band in the tunnel between the [talus](https://durgical.com/en/anatomy/talus/) and heel bone; it steadies the joint below the ankle.

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## What it is

A strong, flat band in the tunnel between the talus and the heel bone (the sinus tarsi).

## What it does

Ties the talus to the heel bone and steadies the joint below the ankle (the subtalar joint).

## Key points

- With the cervical ligament (more laterally, in the sinus tarsi) it is the central stabiliser of the subtalar joint
- Can be torn in severe inversion sprains, leading to subtalar instability or sinus tarsi syndrome
- Must rupture for a subtalar dislocation to occur

## Key facts

**Attaches**
Sulcus tali to calcaneal sulcus, filling tarsal sinus and canal

**Function**
Main bond between talus and [calcaneus](https://durgical.com/en/anatomy/calcaneus/); divides subtalar from talocalcaneonavicular joint

**Tight in**
Eversion (some texts: inversion)

## Relations

**Lateral**
Sinus tarsi: the cervical ligament, the roots of the inferior [extensor retinaculum](https://durgical.com/en/anatomy/extensor-retinaculum-of-the-wrist/), fat and the origin of the [extensor digitorum brevis](https://durgical.com/en/anatomy/extensor-digitorum-brevis/)

**Medial**
Medial opening of the tarsal canal behind the sustentaculum tali, where the artery of the tarsal canal (from the [posterior tibial artery](https://durgical.com/en/anatomy/posterior-tibial-artery/)) enters to supply much of the talar body

**Behind**
Posterior subtalar joint (posterior facet)

**In front**
Talocalcaneonavicular joint (middle and anterior facets and the talar head)

## How to find it

Not palpable itself. Its lateral entrance, the sinus tarsi, is a soft hollow just in front of and below the lateral malleolus, easiest to find with the foot turned in.

## Examination

- Point tenderness in the sinus tarsi, with a feeling of hindfoot instability on uneven ground, suggests sinus tarsi syndrome or subtalar instability

## On imaging

MRI on sagittal and coronal images shows it as dark bands in the tarsal canal; in sinus tarsi syndrome, the normal fat is replaced by fluid or scar and the ligaments look torn or thickened. Oblique (Broden) X-rays show the posterior subtalar facet.

## Common problems

- Can be injured in ankle sprains, causing ongoing pain on the outer side of the hindfoot (sinus tarsi syndrome).

## Clinical notes

- Talar neck fractures can tear the artery of the tarsal canal running beside it, contributing to avascular necrosis of the talar body
- Subtalar arthroscopy reaches the ligament through portals in the sinus tarsi
- In subtalar dislocation the foot usually goes medially ('basketball foot'); lateral dislocations are rarer, higher-energy and more often open

## Development

Talocalcaneal coalition, a failure of the two bones to separate, usually involves the middle facet just in front of this ligament and causes a rigid flatfoot in adolescence.

## Test yourself

Think of the answer, then tap the question to see it.

## Where does the talocalcaneal interosseous ligament lie?

In the tarsal sinus and canal, from the sulcus tali to the calcaneal sulcus.

## Which two joints does the talocalcaneal interosseous ligament separate?

The posterior subtalar joint behind and the talocalcaneonavicular joint in front.

## Which ligament must rupture for a subtalar dislocation to occur?

The talocalcaneal interosseous ligament, the main bond between talus and calcaneus.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
ligamentum talocalcaneum interosseum TA2 1928

**Official Spanish (DeCS)**
Ligamento talocalcáneo interóseo DeCS D013380

**English (TA2)**
Talocalcaneal interosseous ligament

## Related

- [Talocalcaneal ligaments](https://durgical.com/en/anatomy/lateral-talocalcaneal-ligament/)
- [Talus](https://durgical.com/en/anatomy/talus/)
- [Calcaneus](https://durgical.com/en/anatomy/calcaneus/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=23032&filter=ths_termall&q=Articulaci%C3%B3n%20Talocalc%C3%A1nea); [Anatomy, Bony Pelvis and Lower Limb, Foot Joints](https://www.ncbi.nlm.nih.gov/books/NBK536941/).

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Representative model, for educational purposes only.

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