From the Guidelines
The ligament that holds together the first and second metatarsal bones is the deep transverse metatarsal ligament, also known as the intermetatarsal ligament. This ligament is crucial for maintaining the stability and alignment of the forefoot, particularly during weight-bearing activities. The deep transverse metatarsal ligament is a strong, fibrous structure that connects the plantar aspects of the first and second metatarsal bones, near their heads. It is part of a series of transverse ligaments that connect all adjacent metatarsal heads, providing stability and support to the forefoot.
The importance of this ligament is highlighted in the context of Lisfranc injuries, which involve damage to the ligaments and bones in the midfoot, including the deep transverse metatarsal ligament 1. In such cases, imaging techniques like CT and MRI are often used to evaluate the extent of the injury and plan treatment. While the literature evidence is limited, ultrasound (US) may also be a useful tool for evaluating Lisfranc injuries, including the assessment of the dorsal component of the Lisfranc ligament 1.
Key points about the deep transverse metatarsal ligament include:
- It connects the first and second metatarsal bones, maintaining their alignment and stability
- It is composed of dense fibrous connective tissue, providing strength and flexibility
- Injury to this ligament can contribute to forefoot instability and conditions like metatarsalgia or hallux valgus (bunion) formation
- Imaging techniques like CT, MRI, and US can be used to evaluate injuries to this ligament and plan treatment.
From the Research
Ligament Holding the First and Second Metatarsal
- The ligament that holds together the first and second metatarsal is the Lisfranc ligament, which is also known as the interosseous ligament 2.
- This ligament is the strongest ligament of the second metatarsal-medial cuneiform articulation and plays a crucial role in maintaining the stability of the Lisfranc joint 2.
- The Lisfranc ligament is located between the medial cuneiform and the second metatarsal bone, and its anatomy is well understood 3, 2.
- However, it's worth noting that there are other ligaments that connect the metatarsal bones, such as the dorsal and plantar ligaments, but the Lisfranc ligament is the most important one in terms of stability and function 2.
Anatomy of the Lisfranc Ligament
- The Lisfranc ligament has a significant cross-sectional area, with an average height, width, and area that is larger than the other ligaments in the Lisfranc joint 2.
- The ligament is also accompanied by accessory ligaments that provide additional support and stability to the joint 4.
- The anatomy of the Lisfranc ligament is complex, and its classification is still a topic of debate among researchers 4.
Clinical Significance
- The Lisfranc ligament plays a crucial role in maintaining the stability of the Lisfranc joint, and injuries to this ligament can lead to significant functional impairment and disability 3, 5.
- The treatment of Lisfranc injuries depends on the severity of the injury and the stability of the joint, and can range from conservative management to surgical intervention 3, 5.
- A thorough understanding of the anatomy and function of the Lisfranc ligament is essential for the diagnosis and treatment of Lisfranc injuries 3, 2.