Jump to content
We need you! See something you could improve? Make an edit and help improve WikSM for everyone.

Tarsometatarsal Joint

From WikiSM

Introduction

  • Joints of the foot[1]
    Joints of the foot[1]
  • Typical mechanism for a low energy/velocity Lisfranc injury[2]
    Typical mechanism for a low energy/velocity Lisfranc injury[2]
  • The dorsal translation of the first metatarsal at the first tarsometatarsal joint was defined as a step-off or discontinuation of the curvature along of the plantar or dorsal borders of the medial cuneiform and the first metatarsal on parasagittal cut at the mediolateral center of the TMT joint[3]
    The dorsal translation of the first metatarsal at the first tarsometatarsal joint was defined as a step-off or discontinuation of the curvature along of the plantar or dorsal borders of the medial cuneiform and the first metatarsal on parasagittal cut at the mediolateral center of the TMT joint[3]
  • Medial view of the first tarsometatarsal (TMT) joint. Arrows show the slides in the sagittal plane[4]
    Medial view of the first tarsometatarsal (TMT) joint. Arrows show the slides in the sagittal plane[4]
  • A–C, Photographs of gross anatomic section (A) and transverse oblique proton density images after intraarticular injection of gadolinium solution, without (B) and with (C) fat saturation, show Lisfranc ligament (arrows) extending from lateral surface of C1 to medial aspect of M2. Note striated appearance and intermediate signal intensity in MR images[5]
    A–C, Photographs of gross anatomic section (A) and transverse oblique proton density images after intraarticular injection of gadolinium solution, without (B) and with (C) fat saturation, show Lisfranc ligament (arrows) extending from lateral surface of C1 to medial aspect of M2. Note striated appearance and intermediate signal intensity in MR images[5]
Diagram and radiographs showing Lisfranc anatomy. (A) Anatomic Lisfranc joint dorsal surface. The dorsal Lisfranc ligament extends from the medial cuneiform (mc) to the second metatarsal (sm). Dorsal intercuneiform ligaments unite the second through fifth metatarsal bases. Interosseous and plantar ligaments parallel the dorsal ligaments. (From Manaster BJ, Crim JR, Rosenberg Z. Diagnostic and surgical imaging anatomy: knee, ankle, foot. Salt Lake City (UT): Amirsys Publishing Co.; 2007; with permission from Amirsys, Inc.) (B) Anteroposterior radiograph of Lisfranc joint. The first metatarsal is centered on the medial cuneiform. The medial margin of the second metatarsal is aligned with the medial margin of the middle cuneiform (arrowhead). The tuberosity of the fifth metatarsal bases (fmb) extends slightly beyond the lateral margin of the cuboid (cub) (black arrow). (C) Lateral radiograph of Lisfranc joint. The first and second tarsometatarsal joints are both at the dorsal aspect of the foot, but the second tarsometatarsal joint is proximal to the first. The dorsal margins of the middle cuneiform and second metatarsal base are aligned (arrowhead).[6]
Lisfranc joint cross section with the dorsal, interosseous, and plantar oblique ligaments[7]
Normal anatomy of Lisfranc joint. Intricate ligamentous insertions help to stabilize the Lisfranc joint, including the Lisfranc ligament complex, and intermetatarsal and tarsometatarsal ligaments. Only the dorsal ligaments are noted in this drawing.[8]

Alternative Names

  • Lisfranc Joint
  • Tarsal-metatarsal Joint
  • Lisfranc joint complex
  • TMT joint
  • Midfoot joint complex

Description

  • Proximal Bones
  • Distal Bones
    • Metatarsals 1 through 5
    • Second metatarsal is keystone between medial, lateral cuneiforms

3 columns of the midfoot[9]

  • Medial column: articulation between the first metatarsal and the medial cuneiform
  • Middle column: 2nd, 3rd metatarsals articulation with the middle, lateral cuneiforms
  • Lateral column: 4th, 5th metatarsals articulation with the cuboid

Lisfranc Ligamentous Complex

  • Metatarsal Interosseous Ligaments
    • Strongest of the ligaments structures
    • There is no intermetarsal ligament between the first and second metatarsal bases
    • Thin dorsal ligaments connect the second, third, fourth and fifth metatarsals.
  • Lisfranc ligament
    • “Y” shaped interosseous ligament is the main stabilizer
    • Plantar structure extends from the lateral aspect of the medial cuneiform to the medial aspect of the second metatarsal base.
    • The strength of this ligament is such that its disruption will lead to altered stability within the medial and middle columns of the foot.

Actions

  • Allow some dorsiflexion and plantarflexion
  • Small amounts of inversion and eversion
  • Movement during phases of gait

Vascular

  • Dorsalis Pedis Artery
  • Medial and Lateral Plantar Arteries
  • Anastomotic Network

Innervation from Branches of

(A and B), Subtle Lisfranc injury which went unnoticed for 2 mo. A primary four corner arthrodesis was decided[10]
Oblique radiographs of a Lisfranc injury and normal right foot. The rotation and loss of articular congruity of the fi rst cuneiform in the Lisfranc lesion leads to alteration of the anatomic pro fi le of the foot. The line traced on the medial border from the second metatarsal to the medial border of second cuneiform is continued in the normal foot (green line) and disrupted in the Lisfranc lesion (red lines)[11]

Clinical Significance

Pathology

Procedure

See Also

References

  1. ↑ Case courtesy of Andrew Murphy, Radiopaedia.org, rID: 99469
  2. ↑ Lorenz, Daniel S., and Chad Beauchamp. "Functional progression and return to sport criteria for a high school football player following surgery for a lisfranc injury." International journal of sports physical therapy 8.2 (2013): 162.
  3. ↑ Lee, Hee Young, et al. "Does metatarsus primus elevatus really exist in hallux rigidus? A weightbearing CT case–control study." Archives of orthopaedic and trauma surgery 143.2 (2023): 755-761.
  4. ↑ Coskun, Nigar, et al. "Densitometric analysis of the human first tarsometatarsal joint." Surgical and Radiologic Anatomy 28.2 (2006): 135-141.
  5. ↑ Castro, Miguel, et al. "Lisfranc joint ligamentous complex: MRI with anatomic correlation in cadavers." American Journal of Roentgenology 195.6 (2010): W447-W455.
  6. ↑ Crim, Julia. "MR imaging evaluation of subtle Lisfranc injuries: the midfoot sprain." Magnetic resonance imaging clinics of North America 16.1 (2008): 19-27.
  7. ↑ Chen, Jie, Navraj Sagoo, and Vinod Kumar Panchbhavi. "The Lisfranc Injury: A Literature Review of Anatomy, Etiology, Evaluation, and Management." Foot & Ankle Specialist (2020): 1938640020950133.
  8. ↑ Tafur, Monica, Zehava Sadka Rosenberg, and Jenny T. Bencardino. "MR imaging of the midfoot including Chopart and Lisfranc joint complexes." Magnetic Resonance Imaging Clinics 25.1 (2017): 95-125.
  9. ↑ Peicha, G., et al. "The anatomy of the joint as a risk factor for Lisfranc dislocation and fracture-dislocation: an anatomical and radiological case control study." The Journal of bone and joint surgery. British volume 84.7 (2002): 981-985.
  10. ↑ Romero, Jorge De-las-Heras. "Classification and management of Lisfranc joint injuries: current concepts." Current Orthopaedic Practice 27.6 (2016): 680-685.
  11. ↑ Salvi, Andrea Emilio. "Lisfranc injuries: a matter of ligament disruption." The Journal of Foot and Ankle Surgery 53.5 (2014): 674-676.
Created by:
John Kiel on 26 June 2019 00:13:03
Authors:
Last edited:
31 December 2025 22:50:56
Category:
Retrieved from "https://wikism.org/w/index.php?title=Tarsometatarsal_Joint&oldid=39648"