Deltoid ligament of the ankle

The complex of the medial collateral ligaments of the ankle joint is collectively called deltoid ligament. It attaches the medial malleolus to multiple tarsal bones.

Gross anatomy

The ligament is composed of two layers. The superficial layer has variable attachments and crosses two joints while the deep layer has talar attachments and crosses one joint:

It is a strong triangular band attached to the apex and the anterior and posterior borders of the medial malleolus. The plantar calcaneonavicular ligament can be considered part of the medial ligament complex.

• superficial layer:: from anterior to posterior

  • tibionavicular ligament (anterior)

    • pass forwards to the navicular tuberosity behind which they blend with the medial margin of the plantar calcaneonavicular ligament

  • tibiospring ligament

    • descends vertically and blends with the fibres of the spring ligament

  • tibiocalcaneal ligament (intermediate)

    • descend almost vertically to the entire length of the sustentaculum tali 

  • superficial posterior tibiotalar ligament (posterior)

    • pass posterolateral to the medial side of the talus and its medial tubercle

• deep layer: this layer is intra-articular and is covered by synovium

  • anterior tibiotalar ligament (ATTL) 

    • short and thin ligament, pass from the tip of the medial malleolus to the non-articular part of the medial talar surface

    • crossed by the tendons of the tibialis posterior and flexor digitorum longus

  • deep posterior tibiotalar ligament (DPTTL)

    • large and strong ligament from the medial malleolus to the talus

    • covered by the  superficial posterior tibiotalar and tibiocalcaneal ligaments

Related pathology

• deltoid ligament injury

  • grading of deltoid ligament sprains