Dorsal tarsometatarsal ligaments

At a glance

English

Dorsal tarsometatarsal ligaments

Latin (TA2)

Ligamenta tarsometatarsea dorsalia

System

Ligament

Region

Foot

Side

Paired, left and right

About the dorsal tarsometatarsal ligaments

The dorsal tarsometatarsal ligaments reinforce the upper side of the tarsometatarsal joints, the row of plane synovial joints across the midfoot where the tarsus gives way to the metatarsus. Each is a short, flattened but tough strip lying on the joint capsule, under the long extensor tendons and the dorsal vessels of the foot. With the plantar and interosseous ligaments of the same joints, they keep the metatarsal bases pressed against the three cuneiforms and the cuboid.

Their layout mirrors the shape of the bones. The first metatarsal base meets only the medial cuneiform and is held to it by one wide, thin sheet. The second metatarsal base is set into a recess between the medial and lateral cuneiforms, so it is tied by a separate band from each of the three cuneiforms. The third metatarsal takes a single band from the lateral cuneiform. Two bands, from the lateral cuneiform and the cuboid, hold the fourth, and the cuboid alone sends one to the fifth.

Because the second metatarsal is keyed into the cuneiforms and anchored from several sides, it forms the stiffest point of the forefoot. Movement at these joints is limited to slight gliding, which lets the front of the foot accommodate uneven ground; the first ray and the two lateral rays move a little more than the middle ones.

Damage to this joint complex is called a Lisfranc injury. It ranges from a ligament sprain to fracture-dislocation of the metatarsal bases and is easily overlooked on plain films. As the dorsal ligaments are weaker than the plantar ones, the bases tend to displace upwards. Midfoot swelling and bruising in the sole after a twisting or crushing injury should prompt a careful search for it.

Attachments and function

Attaches from

The dorsal surfaces of the medial, intermediate and lateral cuneiforms and of the cuboid.

Attaches to

The dorsal surfaces of the bases of the first to fifth metatarsals.

Function

Hold the metatarsal bases to the distal tarsal row and limit gliding at the tarsometatarsal joints, keeping the forefoot stable while letting it adapt to the ground.

Nerve supply

Articular twigs of the deep fibular nerve reach the dorsal side of these joints.

Blood supply

Branches of the dorsalis pedis artery, mainly the arcuate and lateral tarsal arteries.