Dorsal intercuneiform ligaments

At a glance

English

Dorsal intercuneiform ligaments

Latin (TA2)

Ligamenta intercuneiformia dorsalia

System

Ligament

Region

Foot

Side

Paired, left and right

About the dorsal intercuneiform ligaments

The three cuneiform bones, medial, intermediate and lateral, lie in a row in front of the navicular and behind the bases of the first three metatarsals. They are wedge-shaped, broad on the dorsum and narrow towards the sole, so that set side by side they form part of the transverse arch of the foot. The dorsal intercuneiform ligaments run across their upper surfaces, one between the medial and intermediate bones and one between the intermediate and lateral bones.

Each ligament is a short, flat band of fibres running roughly transversely. Similar bands lie on the plantar side, and strong interosseous ligaments join the rough facing surfaces deep between the bones. A related dorsal cuneocuboid ligament carries the same arrangement laterally, from the lateral cuneiform to the cuboid. The intercuneiform joints themselves are small plane synovial joints whose cavities are continuous with that of the cuneonavicular joint.

The intermediate cuneiform is shorter than its neighbours, so its front end is recessed and forms a socket for the base of the second metatarsal. This mortise, held firm by the intercuneiform and tarsometatarsal ligaments and by the Lisfranc ligament from the medial cuneiform, makes the second ray the stiff keystone of the midfoot. The dorsal intercuneiform ligaments allow only slight gliding and help keep this keystone in place.

These ligaments are torn in some midfoot sprains and in the Lisfranc injury complex. When the injury runs between the medial and intermediate cuneiforms, a widened gap between them can be seen on weight-bearing X-rays, and the instability may need fixing with screws. Missed injuries often lead to collapse of the arch and arthritis.

Attachments and function

Attaches from

Dorsal surfaces of the medial and intermediate cuneiform bones.

Attaches to

Dorsal surfaces of the neighbouring intermediate and lateral cuneiform bones.

Function

Bind adjacent cuneiforms, allow only slight gliding and help maintain the transverse arch and the socket for the second metatarsal.

Nerve supply

Articular twigs of the deep fibular nerve.

Blood supply

Tarsal branches of the dorsalis pedis artery and the arcuate artery.