Endoscopic Repair of the Superficial Deltoid Ligament and Spring Ligament  Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S.  Arthroscopy Techniques  Volume 5, Issue 3, Pages e621-e625 (June 2016) DOI: 10.1016/j.eats.2016.02.004 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Endoscopic repair of superficial deltoid ligament and spring ligament in a right foot. (A) The proximal portal is located 1 cm proximal to the medial malleolar tip, and the distal portal is located close to the navicular insertion of the tendon. (B) Posterior tibial tendoscopy is performed with the proximal portal as the viewing portal. (C) An arthroscopic view shows the torn tibio-spring ligament (TSL), and the talar head (TH) is exposed. The posterior tibial tendon (PTT) is retracted in a plantar direction. (D) An arthroscopic view shows the tear at the superomedial calcaneonavicular ligament (SMCNL). Arthroscopy Techniques 2016 5, e621-e625DOI: (10.1016/j.eats.2016.02.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Endoscopic repair of superficial deltoid ligament and spring ligament in a right foot. (A) Passing of suture loop through the distal stump of the tibio-spring ligament by means of a CPR Viper suture passer through the distal portal. (B) An arthroscopic view shows that the head of the passer slips under the distal stump of the tibio-spring ligament (TSL). (C) The suture loop is retrieved to the distal portal, and the suture limbs pass through the loop. (D) The suture loop holds the distal stump of the tibio-spring ligament after tightening of the suture. (TH, talar head.) Arthroscopy Techniques 2016 5, e621-e625DOI: (10.1016/j.eats.2016.02.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Endoscopic repair of superficial deltoid ligament and spring ligament in a right foot. (A) A bite of the deep stump of the superomedial calcaneonavicular ligament (SMCNL) is obtained by the Viper suture passer through the high distal portal. (B) The stump is held by the suture loop. (C) The suture is retrieved to the distal portal by an arthroscopic probe. (TH, talar head.) Arthroscopy Techniques 2016 5, e621-e625DOI: (10.1016/j.eats.2016.02.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Endoscopic repair of superficial deltoid ligament and spring ligament in a right foot. (A) Repair of the ligaments by means of a knot pusher through the distal portal. (B) Arthroscopic view after repair of ligaments. (SMCNL, superomedial calcaneonavicular ligament; TSL, tibiospring ligament.) Arthroscopy Techniques 2016 5, e621-e625DOI: (10.1016/j.eats.2016.02.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions