The anterior component of the deltoid ligament is made up of two bands that leave the front of the medial malleolus. The superficial tibionavicular band runs forward to the navicular tuberosity and blends with the spring ligament, while the deep anterior tibiotalar band is a short, sometimes absent band to the medial side of the talar neck. Together they check the talus and foot against eversion, abduction and plantarflexion at the front of the medial ankle.
Limits eversion, abduction and external rotation of the talus at the front of the medial ankle, especially in plantarflexion; the tibionavicular band also helps support the medial longitudinal arch with the spring ligament.
The anterior deltoid bands are often torn in eversion and external rotation ankle injuries, including ankle fractures where the deltoid ruptures instead of the medial malleolus breaking. Widening of the medial clear space on a stress radiograph points to deltoid insufficiency. Chronic laxity of the tibionavicular band and spring ligament can contribute to progressive flatfoot deformity.
In external rotation ankle fractures the deltoid ligament can tear instead of the medial malleolus fracturing, allowing the talus to shift laterally. It is suspected when the medial clear space widens on stress radiographs.
Eversion injury sprains the anterior deltoid bands, causing pain and swelling below and in front of the medial malleolus. It is much less common than lateral ankle sprain.
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