The anterior deep tibiotalar ligament connects the anterior colliculus of the medial malleolus to the anterior medial talus body, providing anterior medial talar constraint.
Resists anterior talar displacement from the medial side, provides anterior component of deep medial ankle stability.
Anteromedial ankle arthroscopy must respect the anterior deep deltoid course to avoid inadvertent injury. Combined ATFL and anterior deep deltoid disruption produces more significant anterior instability than isolated ATFL tear.
Combined lateral ATFL and medial anterior deltoid disruption producing global anterior ankle instability, requiring complete ligament complex reconstruction.
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