Anterior tibiotalar ligament

The deep anterior tibiotalar ligament is one of the two components of the deep layer of collateral medial ligament (deltoid ligament complex) on the medial side of the ankle. It courses from the medial malleolus of the tibia to the medial surface of the talar body, specifically attaching to the anteriormedial aspect of the talus.

The deep layer consists of two bands:

• Deep anterior tibiotalar ligament originates from the anterior colliculus and intercollicular groove of the medial malleolus and inserts onto the anteromedial surface of the talar body.

• Deep posterior tibiotalar ligament the larger and more consistently present deep component, inserting onto the posteromedial talar body.

The deep anterior tibiotalar ligament is a variable component of the deltoid complex. Studies report its prevalence ranging from approximately 63 to 92% of specimens.

The deep deltoid ligaments (both anterior and posterior tibiotalar) are the primary restraints to lateral talar translation and external rotation of the talus within the ankle mortise.

Its smaller size compared to the deep posterior tibiotalar ligament and its variable presence make it a less dominant but clinically relevant stabilizer of the medial ankle.