Ankle ligament injuries occur frequently during recreational activities as well as competitive sports1. Although most heal with little medical intervention, recurrent instability can occur in 15% to 48% of patients2-6 and long-term sequelae can occur in up to 50% of patients7. Even following nonoperative treatment such as physiotherapy, bracing, or medication, continued problems may require surgical intervention, and the normal stability and biomechanics of the ankle joint should be reestablished to prevent the development of arthritis8,9. Several procedures for the reconstruction of the lateral ankle ligaments have been proposed, and the overall success rates of these operations have been reported to be >80%6,9-15. However, reconstruction of the deltoid ligament has received relatively little attention16-20. Moreover, operative management of chronic global ankle instability, including an incompetent deep deltoid ligament, has rarely been described, to the best of our knowledge18,21. We present a case of combined insufficiency of the medial and lateral ankle ligaments that was treated successfully with simultaneous reconstruction of those ligaments with a semitendinosus tendon allograft. The patient was informed that data concerning the case would be submitted for publication, and he consented. A thirty-six-year-old man presented with discomfort in the left ankle. He had sustained an ankle injury seven years earlier during a soccer game, after which recurrent sprains had often occurred with only minor exertion. He did not participate in sports activity as much as he wanted to because of a feeling of the ankle giving way. He was seen at our clinic with symptoms of instability and a clunking sensation in the ankle joint two months after sustaining another, severe ankle injury. On physical examination, there was no effusion or swelling …