• Deltoid ligament (DL) injuries are common in ankle trauma, yet their optimal management remains debated.
• Most trauma literature considers DL injury as an isolated ankle problem, whereas foot-and-ankle specialists view the
ankle and the foot as a complex. This disconnect leaves a critical knowledge gap that our work aims to address.
• As we know, every post-traumatic collapsing foot deformity involves a DL injury, but not every DL necessarily
progresses to such a deformity.
• We introduce the concept of the DL as a tri-articular stabilizer within the medial ankle ligament complex, contributing to
the stability of the tibio-talar, subtalar (ST), and talo-navicular (TN) joints.
• Neglecting this broader stabilizing role may lead to irreversible foot sequelae, such as post-traumatic plano-valgus or
plano-abductus deformities. Therefore, DL injuries should be systematically recognized in both acute and chronic
settings, whether treated conservatively or surgically.
• In this expert opinion, we synthesize current anatomical, biomechanical, and clinical evidence together with our
experience to outline key diagnostic principles and therapeutic considerations for the management of DL injuries.
