Biomedical Research

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Anatomy of the ligaments between the first cuneiform and the base of the second metatarsal and its clinical significance

Background: This study aimed to investigate the anatomic characteristics of the ligaments between the first cuneiform and the base of the second metatarsal, which might improve the treatment of Lisfranc injury.

Methods: Twenty fresh foot specimens of normal adults were dissected. The length and width of the dorsal, plantar and Lisfranc ligaments were measured. Morphology of Lisfranc ligament and its origin on the first cuneiform were observed and investigated.

Results: The length and width of dorsal ligaments were 5.44 ± 0.83 mm and 4.20 ± 0.64 mm; those of plantar ligament were 7.07 ± 1.05 mm and 5.23 ± 1.10 mm; and those of Lisfranc ligament were 9.33 ± 1.34 mm and 8.00 ± 1.23 mm, respectively. The included angle between Lisfranc ligament and the proximal end of the shaft of the second metatarsal bone was 61.45 ± 5.03°. Lisfranc ligament was located on the lateral surface of the first cuneiform. The origin of Lisfranc ligament was 10.89 ± 0.84 mm away from the dorsal side of the first cuneiform, 8.31 ± 0.92 mm away from the plantar region, 5.35 ± 0.60 mm away from the distal end, and 12.04 ± 0.85 mm away from the proximal end.

Conclusions: The Lisfranc ligament is the largest one in the Lisfranc complex, plantar ligament is the second largest, and the dorsal ligament is the smallest. The internal fixation for the treatment of Lisfranc injury can be performed based on the location of the origin of Lisfranc ligament and the included angle between the ligament and the shaft of the second metatarsal bone.

Author(s): Hui Zhu, Chun-Guang Li, Guang-Rong Yu, Yun-Feng Yang, Bing Li