# Morphometric and Anatomical Analysis of the Deltoid Ligament Complex: A Cadaveric Study in the Southeast Asian Population

## TL;DR

This study measures the deltoid ligament in Southeast Asian cadavers to understand its anatomy and improve ankle surgery outcomes.

## Contribution

Provides new morphometric data on the deltoid ligament complex specific to the Southeast Asian population.

## Key findings

- The tibionavicular ligament was the longest, and the deep posterior tibiotalar ligament was the shortest in the deltoid ligament complex.
- The mean lengths of certain ligaments in the Southeast Asian population were longer than those reported in European studies.
- All components of the deltoid ligament complex were present in all specimens analyzed.

## Abstract

Introduction

The deltoid ligament complex (DLC) confers stability of the ankle joint. This study quantitatively analyzes the morphometry of the DLC in the Southeast Asian population, highlighting anatomical variations relevant to surgical procedures.

Methodology

Seven embalmed amputated limbs were dissected. The width and length of the superficial and deep layers with their corresponding bands were measured using a metric ruler.

Results

The mean width of the superficial layer of the DLC was 20.43 + 2.72 mm at the origin, 20.00 + 1.07 mm at midway, and 15.29 + 1.28 mm at insertion. The tibionavicular ligament (TNL), tibiocalcaneal ligament (TCL), deep posterior tibiotalar ligament (dPTTL), and the deep anterior tibiotalar ligament (dATTL) were present in all specimens. In the superficial layer, the mean length of the TNL and TCL was 38.57 + 3.58 mm and 34.29 + 6.47 mm, respectively. In the deep layer, the mean length of the dPTTL and dATTL was 18.71 + 1.83 mm and 20.29 + 2.31 mm, respectively.

Conclusion

While the prevalence of the components of the DLC varies widely across the literature, it was present in all specimens of our study. The longest and shortest bands of the DLC were the TNL and dPTTL, respectively, concurring with current literature. However, the mean length of TCL, dPTTL, and dATTL in the Southeast Asian population appeared to be longer than that reported in a meta-analysis of European cadaveric studies. Knowledge of the morphology and anatomical variations of each component of the DLC in the Southeast Asian population is crucial to improve surgical management of medial ankle instability.