Deltoid Ligament Insufficiency

Deltoid ligament insufficiency can be present after an ankle sprain or fracture and in the setting of adult acquired flatfoot. If symptoms of medial ankle instability persist after nonoperative treatment for an ankle sprain, deltoid ligament repair or reconstruction may be indicated. More commonly, deltoid ligament injuries occur at the time of rotational ankle fractures. The indications for acute deltoid ligament repair in the setting of fracture are of great interest and debate. This chapter will review the conditions of deltoid ligament insufficiency in the setting of sprains and fractures including the current state of evidence and technique for operative repair.Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.