Metatarsals: Difference between revisions
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===== Fractures ===== | ===== Fractures ===== | ||
Metatarsal fractures are common foot injuries that are caused by torsion forces or a direct strike. Many of these fractures can be treated successfully with good outcomes. Metatarsal fractures that progress to malunion or nonunion, on the other hand, can cause metatarsalgia or midfoot arthritis. Stress fractures, usually an overuse injury that leads to a thin crack in bone, can also occur in the metatarsals. Stress fractures can also be seen in patients with metabolic bone disease, rheumatoid arthritis <ref>Cothran VE. Metatarsal Stress Fracture. Medscape 2019. <nowiki>https://emedicine.medscape.com/article/85746-overview</nowiki> (accessed May 29, 2021).</ref>. | |||
The following is a list of fractures specific to the metatarsals of the foot: | |||
* ''Dancer’s Fractures (Avulsion fracture of the base of the 5th metatarsal)'' | |||
* ''Jones Fractures (5th metadiaphyseal stress fractures)'' | |||
* ''Metatarsal base fractures and Lisfranc injuries'' | |||
* ''Metatarsal stress fractures'' | |||
* ''Neuropathic metatarsal fractures'' | |||
===== Gout ===== | ===== Gout ===== | ||
Revision as of 06:11, 13 June 2021
Original Editor - Shejza Mino
Top Contributors - Shejza Mino, Lucinda hampton, Kim Jackson, Wendy Snyders and Vidya Acharya
Introduction[edit | edit source]
The metatarsals refer to five long bones that are located in each foot. They are numbered I to V, from medial to lateral.
Together, the metatarsal and tarsal bones help to form the arches of the foot, which are essential for weight-bearing as well as walking.
Gross Anatomy & Structure[edit | edit source]
The metatarsal bones start at the tarsus and end at the phalanges, forming two joints: the tarsometatarsal joint & metatarsolphalangeal joint.
Each of the metatarsal bones consists of the following:
- proximal base
- shaft (aka body)
- neck
- distal head
Articulations[edit | edit source]
Each base of the metatarsal bone articulates with at least one of the tarsal bones, forming the tarsometatarsal joints. The head of the metatarsals articulate with the phalanges, making up the metatarsalphalangeal joints. Additionally, the base of the metatarsals also articulates with the base of the adjacent metatarsal, forming the intermetatarsal joints.
| Bone (metatarsal) | Proximal articulation | Distal articulation |
|---|---|---|
| Metatarsal I | medial cuneiform | 1st proximal phalanx |
| Metatarsal II | medial, intermediate & lateral cuneiforms | 2nd proximal phalanx |
| Metatarsal III | lateral cuneiform | 3rd proximal phalanx |
| Metatarsal IV | cuboid | 4th proximal phalanx |
| Metatarsal V | cuboid | 5th proximal phalanx |
Attachments[edit | edit source]
| Metatarsal | Muscle attachment |
|---|---|
| Metatarsal I | - Base: tibialis anterior, fibularis longus
- Tuberosity: fibularis longus - Lateral shaft: 1st dorsal interosseous |
| Metatarsal II | - Medial shaft: 1st dorsal interosseous
- Lateral shaft: 2nd doral interosseous |
| Metatarsal III | - Medial shaft: 2nd dorsal interosseus & 1st plantar interosseus
- Lateral shaft: 3rd dorsal interosseous |
| Metatarsal IV | - Medial shaft: 3rd dorsal interosseus & 2nd plantar interosseus
- Lateral shaft: 4th dorsal interosseus |
| Metatarsal V | - Medial shaft: 4th dorsal interosseus & 3rd plantar interosseus
- Dorsal base: fibularis tertius - Tuberosity: fibularis brevis - Plantar base: flexor digiti minimi brevis |
Ligamentous[edit | edit source]
There are four deep transverse metatarsal ligaments (DTML) that bridge the head of the metatarsal bones. Specifically, they run "between the distal ends of adjacent metatarsal bones and intersect with the plantar ligaments of the metatarsophalangeal joint"[1].
Arches of the Foot[edit | edit source]
The metatarsals contribute significantly to the three arches of the foot. The bones that contribute to each arch are as follows:
- Medial longitudinal arch: talus, calcaneus, navicular, all three cuneiforms and metatarsals 1-3.
- Lateral longitudinal arch: calcaneus, cuboid and metatarsals 4 & 5.
- Transverse arch: bases of all five metatarsals, cuboid and cuneiforms 1-3.
Clinical Significance[edit | edit source]
Fractures[edit | edit source]
Metatarsal fractures are common foot injuries that are caused by torsion forces or a direct strike. Many of these fractures can be treated successfully with good outcomes. Metatarsal fractures that progress to malunion or nonunion, on the other hand, can cause metatarsalgia or midfoot arthritis. Stress fractures, usually an overuse injury that leads to a thin crack in bone, can also occur in the metatarsals. Stress fractures can also be seen in patients with metabolic bone disease, rheumatoid arthritis [2].
The following is a list of fractures specific to the metatarsals of the foot:
- Dancer’s Fractures (Avulsion fracture of the base of the 5th metatarsal)
- Jones Fractures (5th metadiaphyseal stress fractures)
- Metatarsal base fractures and Lisfranc injuries
- Metatarsal stress fractures
- Neuropathic metatarsal fractures
Gout[edit | edit source]
Gout is a form of crystal-induced arthoropathy, formed by monosodium urate monohydrate crystals. The most common joint affected is the metatarsal-phalangeal joint of the big toe [3]
Hallux valgus[edit | edit source]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ Abdalbary SA, Elshaarawy EA, Khalid BE. Tensile properties of the deep transverse metatarsal ligament in hallux valgus: a CONSORT-compliant article. Medicine. 2016 Feb;95(8).
- ↑ Cothran VE. Metatarsal Stress Fracture. Medscape 2019. https://emedicine.medscape.com/article/85746-overview (accessed May 29, 2021).
- ↑ Rothschild BM. Gout and Pseudogout [Internet]. Practice Essentials, Background, Pathophysiology. Medscape; 2021 [cited 2021May27]. Available from: https://emedicine.medscape.com/article/329958-overview
