Arthroscopic Approach to Deltoid Injuries.

Deltoid ligament injuries may result in medial ankle instability (MAI), recently two subgroups related to an injury of the deep layer have recently been distinguished: dynamic MAI and rotational ankle instability (RAI). Dynamic MAI involves injury to the intermediate part of the deep layer (collicular fibers), usually from unresolved acute trauma. RAI stems from chronic injury of the anterior fibers, often secondary to long-standing lateral ankle instability, and is characterized by abnormal talar rotation and translation. These chronic deep-layer injuries are difficult to detect clinically or radiologically. Arthroscopy is therefore fundamental for accurate diagnosis and management of deltoid ligament injuries.