The deep deltoid ligament contains the anterior and posterior tibiotalar components, the strongest part of the medial ankle ligament complex. These deep fibres resist lateral talar tilt during severe eversion injuries. Isolated deep deltoid tears are rare — the distal fibula usually fractures before the deep deltoid fails under an eversion force.
| Origin | Medial malleolus (anterior and posterior colliculi) |
|---|---|
| Insertion | Medial talar body |
| Actions | Primary medial ankle stability against valgus stress and lateral talar displacement |
|---|
The deep deltoid is assessed by the medial clear space on mortise radiograph — greater than 4 mm indicates deltoid insufficiency. In ankle fracture surgery, medial clear space widening after lateral fixation indicates deep deltoid disruption requiring separate assessment or repair.
Medial ankle ligament disruption in eversion injuries producing medial clear space widening requiring assessment alongside lateral fracture fixation.
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