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The deltoid ligament (or medial ligament of talocrural joint) is a strong, flat, triangular band, attached, above, to the apex and anterior and posterior borders of the medial malleolus. The deltoid ligament supports the ankle joint and also resists excessive eversion of the foot. [1] The deltoid ligament is composed of 4 fibers:
The tibial nerve, posterior tibial artery, posterior tibial vein, and flexor tendons travel in a bundle along this pathway through the tarsal tunnel, in the following order from anteromedial to posterolateral: Tibialis posterior tendon. [2] Flexor digitorum longus tendon. [2] Posterior tibial artery. [2] Posterior tibial vein. [1] Tibial nerve. [2]
On the front of the ankle the sheath for the Tibialis anterior extends from the upper margin of the transverse crural ligament to the interval between the diverging limbs of the cruciate ligament; those for the Extensor digitorum longus and Extensor hallucis longus reach upward to just above the level of the tips of the malleoli, the former being the higher.
[1] [2] The tarsal tunnel is found along the inner leg behind the medial malleolus (bump on the inside of the ankle). The posterior tibial artery, tibial nerve, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles travel in a bundle through the tarsal tunnel.
The muscle ends as a tendon of insertion. The tendon passes through a distinct compartment in the inferior extensor retinaculum of foot. It crosses anterior tibial vessels lateromedially near the bend of the ankle. [citation needed] In the foot, its tendon is situated at along the medial side of the dorsum of the foot. [1]
The summit of the medial malleolus is marked by a rough depression behind, for the attachment of the deltoid ligament. The major structure that passes anterior to the medial malleolus is the saphenous vein. Structures that pass behind medial malleolus deep to the flexor retinaculum: Tibialis posterior tendon; Flexor digitorum longus
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