Stabilization of medial longitudinal foot arch by peroneus longus transfer

• The mechanical integrity of the medial longitudinal arch depends on the dynamic support of muscles and the static support of ligaments.
• Surgical repair of the spring ligament has become an important adjunct to treating posterior tibial tendon abnormalities.
• Peroneus longus tendon transfer may augment medial column stability, although this requires further clinical research.

The mechanical integrity of the medial longitudinal arch depends on the dynamic support of muscles and the static support of ligaments. Although the posterior tibial tendon is the main dynamic stabilizer of the arch, the static structures provide the most support especially while the person is standing. After rupture of the posterior tibial tendon, the spring ligament may be compromised under increased stress and leads to talar derotation and peritalar subluxation. Surgical repair of the spring ligament has become an important adjunct to treating posterior tibial tendon abnormalities. A technique of peroneus longus transfer to augment the static stabilizers of the medial column is described in this article.