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The deltoid ligament (or medial ligament of talocrural joint) is a strong, flat, triangular band, attached, above, to the apex and anterior and posterior borders of the medial malleolus. The deltoid ligament supports the ankle joint and also resists excessive eversion of the foot. [ 1 ]
The ankle joint is bound by the strong deltoid ligament and three lateral ligaments: the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament. The deltoid ligament supports the medial side of the joint, and is attached at the medial malleolus of the tibia and connect in four places to the talar ...
The ligament is strengthened medially by blending with the deltoid ligament of the ankle joint, and is supported inferiorly by the tendon of the tibialis posterior, which is spread out in a fanshaped insertion and prevents undue tension of the ligament or such an amount of stretching as would permanently elongate it. [1]
The summit of the medial malleolus is marked by a rough depression behind, for the attachment of the deltoid ligament. The major structure that passes anterior to the medial malleolus is the saphenous vein. Structures that pass behind medial malleolus deep to the flexor retinaculum: Tibialis posterior tendon; Flexor digitorum longus
Forceful, external rotation of the ankle joint is the main cause of a Maisonneuve fracture. [4] [7] Engaging in high-intensity sports or falling over can increase the risk of tearing the deltoid ligament or cause an avulsion fracture of the medial malleolus from external rotation of the foot.
This happens when, instead of the ankle rotating medially resulting in an inversion injury (the foot rolling too much to the inside), the ankle rotates laterally resulting in an eversion injury (when the foot rolls too much to the outside). When this occurs, the medial, or deltoid, ligament is strained.
The calcaneofibular ligament (CFL), which connects the fibula to the calcaneus, or heel bone, also provides lateral support. The deltoid ligament provides support to the medial part of the ankle (closest to the midline). It prevents the foot from excessively everting, or turning outwards while also preventing the talus from externally rotating. [9]
It passes obliquely forward and lateralward, superficial to the deltoid ligament of the ankle-joint, into the sole of the foot, where it crosses over the tendon of the flexor hallucis longus at the level of the navicular bone at a location known as the knot of henry [6] (also referred to as plantar tendinous chiasm), [2] [3] [4] and receives ...