The superficial deltoid ligament has three components arising from the anterior colliculus: the tibionavicular (most anterior), the tibiocalcaneal (middle), and the tibiospring (most important — connecting to the spring ligament complex). The tibiospring component is the critical link between the deltoid and the spring ligament, making it an essential component in progressive flatfoot deformity assessment.
| Origin | Medial malleolus (anterior colliculus) |
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| Insertion | Navicular, spring ligament, and sustentaculum tali (three superficial components) |
| Actions | Resists eversion and lateral talar displacement; the superficial layer is the primary medial ankle restraint in the pronated position |
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The tibiospring component of the superficial deltoid is assessed on coronal MRI as the ligament running from the anterior colliculus to the superomedial spring ligament. Its disruption contributes to medial ankle and subtalar joint instability in stage II PTTD flatfoot. Repair or reconstruction of the tibiospring component alongside spring ligament reconstruction is required for medial column stabilisation in flatfoot surgery.
Superficial deltoid tibiospring component tear contributing to medial ankle instability in PTTD managed with ligament repair as part of flatfoot reconstruction.
