Four-bundle anatomic deltoid ligament reconstruction: Surgical technique

The deltoid ligament, the strongest medial ankle ligament, is often overlooked in ankle injuries, despite its substantial role in ankle stability. Medial sprains, accounting for 3%-4% of ankle injuries, are frequently misdiagnosed, leading to chronic pain, instability, and hindfoot valgus deformity. While most cases respond to conservative treatment, chronic injuries that fail conservative measures require surgical intervention. This technical paper introduces a novel four-bundle deltoid ligament reconstruction technique, restoring two anterior (superficial and deep) and two posterior (superficial and deep) bundles. This approach provides a solution for severe injuries and high-demand patients, permitting functional stability.

Level V.