Tarsometatarsal, Intermetatarsal, Metatarsophalangeal and Interphalangeal Joints Flashcards
Tarsometatarsal joints
o In these joints, the 5 metatarsals articulate with
the 4 tarsal bones of the distal row
o Gliding joints that are NOT in a straight line
Bones of the tarsometatarsal joint
o First metatarsal – medial cuneiform
o Second metatarsal – medial cuneiform, intermediate cuneiform, lateral cuneiform
o Third metatarsal – lateral cuneiform
o Fourth metatarsal – cuboid and lateral cuneiform
o Fifth metatarsal – cuboid
Position of tarsometatarsal joints
NOT a straight line - Intermediate cuneiform and 2nd metatarsal are set posteriorly
3 joint cavities for tarsometatarsal articulations
- Medial tarsometatarsal joint
- Great tarsal joint
- Lateral tarsometatarsal joint
What bones articulate within the medial tarsometatarsal joint?
• For articulation of the kidney-shaped facets on the base of the 1st metatarsal and the anterior surface of the medial cuneiform
What bones articulate within the great tarsal joint?
- 2nd metatarsal articulates with all 3 cuneiform bones
* 3rd metatarsal articulates with lateral cuneiform
What bones articulate within the lateral tarsometatarsal joint?
- 4th metatarsal articulates with lateral cuneiform and cuboid
- 5th metatarsal articulates with cuboid
What are the three types of ligaments that form these three joint cavities?
- Dorsal
- Plantar
- Interosseous
Dorsal tarsometatarsal ligaments
- Strong, flat bands
- Usually a total of 7 ligaments
7 dorsal tarsometatarsal ligaments
- 1st (medial) dorsal tarsometatarsal ligament - Connects the 1st metatarsal and medial cuneiform
- 2nd -4th dorsal tarsometatarsal ligaments - Connect 2nd metatarsal to medial, intermediate and lateral cuneiforms
- 5th dorsal tarsometatarsal ligament - Connects the 3rd metatarsal and lateral cuneiform
- 6th dorsal tarsometatarsal ligament - Connects 4th metatarsal and cuboid - A slip of this ligament is attached
to the 3rd metatarsal - 7th dorsal tarsometatarsal ligament - Connects 5th metatarsal to cuboid
Plantar tarsometatarsal ligaments
- Plantar tarsometatarsal ligaments are weak and irregular
- Fibers course obliquely as well as longitudinally
- Variable number of ligaments (3-5)
- Ligaments of the first two metatarsals are stronger than those of the last three metatarsals
What do the plantar tarsometatarsal ligaments blend with?
- Long plantar ligament
* Tendon of tibialis posterior
5 plantar tarsometatarsal ligaments
1st and 2nd plantar tarsometatarsal ligament
• Attach proximally to the medial cuneiform
• 1st attaches distally to 1st metatarsal
• 2nd attaches distally to 2nd metatarsal
3rd plantar tarsometatarsal ligament
• Connects 3rd metatarsal to lateral cuneiform
4th plantar tarsometatarsal ligament
• Connects 4th metatarsal to cuboid
5th plantar tarsometatarsal ligament
• Connects 5th metatarsal to cuboid
3 Interosseous tarsometatarsal ligaments
- Lisfranc’s ligament
- Ligament from 2nd metatarsal to lateral cuneiform
- Ligament from 4th metatarsal to lateral cuneiform
Lisfranc’s ligament
o Connects 2nd metatarsal to medial cuneiform
o Most CONSTANT ligament
o Lies between the medial tarsometatarsal joint and the great tarsal join
What is the functional tarsometatarsal joint?
• Lisfranc’s joint is the functional tarsometatarsal joint
It refers to all 3 anatomical joints:
o Medial tarsometatarsal joint
o Lateral tarsometatarsal joint
o Great tarsal joint
Do we name each of these ligaments individually?
NOTE: although you could name each of these ligaments specifically according to the specific bones they attach to, the more general term (listed above) of “tarsometatarsal” is common
Intermetatarsal joints
- 1st and 2nd metatarsals do NOT articulate
- Bases of all other metatarsals articulate with each other
1st and 2nd metatarsals
o Bases of 1st and 2nd metatarsals do NOT articulate
o There are NO ligaments the bases of these two bones
o At times, a bursa may be located between the bases of the 1st and 2nd metatarsals
o Other times, pressure facets may be located on opposable surfaces of bases
o Sometimes a weak interosseous ligament (consisting of a few fibers) is present
All other metatarsals
o Bases of all other metatarsals articulate with each other
o Part of great tarsal joint (2nd and 3rd metatarsals, 3rd and 4th metatarsals)
o Part of lateral tarsometatarsal joint (4th and 5th metatarsal)
o NOTE: at times, the articulation between the 3rd and 4th metatarsals is part of the lateral tarsometatarsal joint instead of the great tarsal joint
Ligament support at intermetatarsal joints
3 ligaments support the articulation between two metatarsals
- Plantar intermetatarsal ligaments
- Dorsal intermetatarsal ligaments
- Interosseous intermetatarsal ligaments
Deep transverse metatarsal ligament
o The heads of all 5 metatarsal are united by the deep transverse metatarsal ligament
o The union between the heads of the 1st and 2nd metatarsals is unique to the human foot (NOT found in other primates)
o Sometimes called the “intercapitular ligament”
o Blends with the glenoid ligaments of the metatarsophalangeal joints
What separates the lumbricals from the interossei muscles?
Deep transverse metatarsal ligament
- Lumbricals pass plantarly to the ligament
- Interossei pass dorsally to the ligament
Metatarsophalangeal joints
o Metatarsophalangeal joints are ellipsoid types of synovial joints
o Rounded convex head of metatarsal articulates with concave base of a proximal phalanx
o The metatarsal heads have a trochlear-shaped surface
