Tarsometatarsal joints
The tarsometatarsal joints (Lisfranc joints) are arthrodial joints in the foot. The tarsometatarsal joints involve the first, second and third cuneiform bones, the cuboid bone and the metatarsal bones. The eponym of Lisfranc joint is 18th–19th-century surgeon and gynecologist Jacques Lisfranc de St. Martin.[1] StructureBonesThe bones entering into their formation are the first, second, and third cuneiforms, and the cuboid bone, which articulate with the bases of the metatarsal bones. The first metatarsal bone articulates with the first cuneiform; the second is deeply wedged in between the first and third cuneiforms articulating by its base with the second cuneiform; the third articulates with the third cuneiform; the fourth, with the cuboid and third cuneiform; and the fifth, with the cuboid. The bones are connected by dorsal, plantar, and interosseous ligaments. Dorsal ligamentsThe dorsal ligaments are strong, flat bands. The first metatarsal is joined to the first cuneiform by a broad, thin band; the second has three, one from each cuneiform bone; the third has one from the third cuneiform; the fourth has one from the third cuneiform and one from the cuboid; and the fifth, one from the cuboid. Plantar ligamentsThe plantar ligaments consist of longitudinal and oblique bands, disposed with less regularity than the dorsal ligaments. Those for the first and second metatarsals are the strongest; the second and third metatarsals are joined by oblique bands to the first cuneiform; the fourth and fifth metatarsals are connected by a few fibers to the cuboid. Interosseous ligamentsThe interosseous ligaments are three in number.
Synovial membraneThe synovial membrane between the first cuneiform and the first metatarsal forms a distinct sac. The synovial membrane between the second and third cuneiforms behind, and the second and third metatarsal bones in front, is part of the great tarsal synovial membrane. Two prolongations are sent forward from it, one between the adjacent sides of the second and third, and another between those of the third and fourth metatarsal bones. The synovial membrane between the cuboid and the fourth and fifth metatarsal bones forms a distinct sac. From it a prolongation is sent forward between the fourth and fifth metatarsal bones. FunctionThe movements permitted between the tarsal and metatarsal bones are limited to slight gliding of the bones upon each other. Clinical significanceA Lisfranc injury is common among athletes. ReferencesThis article incorporates text in the public domain from page 358 of the 20th edition of Gray's Anatomy (1918) External linksAdditional images
|