Fact-checked by Grok 2 weeks ago

Metatarsal bones

The metatarsal bones are a set of five elongated long bones located in the midfoot region of the human foot, positioned between the proximal tarsal bones and the distal phalanges of the toes. Numbered from I to V starting from the medial (big toe) side to the lateral side, they form the structural foundation of the forefoot and are essential for locomotion. Each metatarsal bone consists of three main parts: a proximal base that articulates with the tarsal bones, a central shaft that is typically triangular in cross-section and convex dorsally, and a distal head that connects to the proximal phalanx of the corresponding toe. The bases of the first, second, and third metatarsals articulate with the medial, intermediate, and lateral cuneiform bones, respectively, while the fourth and fifth articulate with the cuboid bone; additionally, adjacent metatarsals connect via intermetatarsal joints for stability. The first metatarsal is the shortest and thickest, providing robust support for the great toe, whereas the second is the longest, and the fifth is more mobile to facilitate foot inversion and eversion. Functionally, the metatarsals bear a significant portion of body weight during standing, walking, and running, distributing forces across the foot's longitudinal and transverse arches to absorb shock and maintain . Together with the tarsal bones, they form the foot's arches, which enhance propulsion and prevent excessive strain on the lower limbs. These bones also serve as key attachment sites for intrinsic foot muscles, tendons, and ligaments, contributing to movements such as toe flexion and foot stabilization. Clinically, the metatarsals are prone to fractures from or stress, such as in athletes, and conditions like highlight their role in .

Anatomy

Location and general features

The metatarsal bones consist of five elongated long bones (numbered I through V) that form the intermediate segment of the foot skeleton, positioned distally to the tarsal bones and proximally to the phalanges of the toes. They occupy the forefoot region, extending anteriorly from the tarsus to support the overall structure of the foot. Each metatarsal exhibits a characteristic of a proximal , a central , and a distal head, with the wedge-shaped and the pyramidal and slightly curved. The bases face posteriorly toward the tarsals, while the heads project anteriorly toward the toes, collectively forming the ball of the foot. These bones are oriented nearly parallel to one another, with a slight medial-to-lateral divergence, and are numbered from the medial (big toe) side to the lateral (little toe) side. The first metatarsal is the shortest and thickest, providing robust support on the medial side, while the second is typically the longest, and the fifth shows a lateral . Their alignment contributes to a subtle transverse arch across the forefoot, which integrates with the foot's longitudinal arch for . In adults, average lengths vary by bone, sex, and population; for instance, the first metatarsal measures approximately 56 mm in males and 50 mm in females, while the second averages 68 mm in males and 62 mm in females, based on radiographic studies. These dimensions underscore the metatarsals' role in defining the forefoot's proportions and load distribution.

Characteristics of individual metatarsals

The first metatarsal is the shortest and thickest of the five metatarsals, featuring a robust prismoid and a rounded with a prominent tuberosity on its plantar surface for the insertion of the peroneus longus tendon. Its head includes two grooved facets to accommodate sesamoid bones. The second metatarsal is the longest among the metatarsals, characterized by a straight and slender and a square-shaped . The third metatarsal exhibits an intermediate length relative to the others, with a triangular base and a shaft similar in form to that of the second but slightly more tapered. The fourth metatarsal is more slender than the third, possessing a quadrangular base and a narrower shaft overall. The fifth metatarsal, distinguished by its lateral position and a prominent styloid , or tuberosity, at the base for the attachment of the peroneus brevis tendon. In human , the comparative proportions of the metatarsals typically follow an "index-minus" configuration, where the second is the longest, followed by the first, third, fourth, and fifth in descending order (metatarsal formula: 2 > 1 > 3 > 4 > 5).

Articulations and ligaments

The bases of the metatarsal bones articulate proximally with the distal surfaces of the and bones to form the , collectively known as the Lisfranc joint complex. Specifically, the base of the first metatarsal articulates with the medial , the second metatarsal base with the intermediate , the third with the lateral , and the bases of the fourth and fifth metatarsals with the . These joints are classified as plane synovial joints, permitting limited gliding movements while maintaining midfoot stability. The Lisfranc ligament provides critical reinforcement to this complex, comprising three components: a ligament, an interosseous , and a plantar ligament that collectively connect the medial cuneiform to the base of the second metatarsal. Additional stability arises from interosseous ligaments between adjacent metatarsal bases, as well as and plantar intermetatarsal ligaments that span the bases of metatarsals II–V. The intermetatarsal joints themselves are small synovial plane joints formed between the lateral aspects of adjacent metatarsal bases, bound by these strong fibrous connections consisting of transverse fibers. Distally, the rounded heads of the metatarsal bones articulate with the bases of the proximal phalanges to form the metatarsophalangeal (MTP) joints. These are condyloid synovial , characterized by the reception of the metatarsal heads into shallow cavities on the phalangeal bases, enabling flexion, extension, and limited /adduction; the bases of the proximal phalanges are slightly to receive the metatarsal heads, enhancing during motion. The heads of adjacent metatarsals are interconnected by the deep transverse metatarsal , a narrow fibrocartilaginous band that runs across and blends with the plantar aspects of the MTP joint capsules, helping to maintain forefoot alignment.

Blood supply and innervation

Vascular anatomy

The arterial supply to the metatarsal bones derives primarily from the dorsally and the medial and lateral plantar arteries plantarily, ensuring comprehensive perfusion of the forefoot structures. The , a continuation of the anterior tibial artery, terminates by dividing into the first dorsal metatarsal artery, which supplies the , while its arcuate branch gives rise to the second, third, and fourth dorsal metatarsal arteries that course along the dorsum of the respective metatarsals II through IV. Plantarly, the lateral plantar artery, arising from the , anastomoses with the deep branch of the dorsalis pedis to form the deep plantar arch, from which the four plantar metatarsal arteries emerge to supply the interosseous spaces and the plantar aspects of the metatarsals. Specifically, the first metatarsal receives additional supply from branches of the medial plantar artery, while the second metatarsal is nourished by the deep plantar arch; these vessels form extensive anastomoses across the forefoot to maintain redundancy in circulation. Intraosseous vascularization of the metatarsals is provided by that originate from the or plantar metatarsal arteries and enter the primarily at the middle third of the shafts for the second through fourth metatarsals, typically via a single directed obliquely proximally to supply the . For the second through fourth metatarsals, these enter the lateral or medial plantar aspects just proximal to the midpoint, whereas in the fifth metatarsal, the arises from the fourth plantar metatarsal artery and inserts into the plantar medial near the junction of the middle and proximal thirds. The first metatarsal's , stemming from the first metatarsal artery, enters the medial aspect at the distal third or the junction of the middle and distal thirds of the , oriented obliquely from a proximal direction in the . Venous drainage from the metatarsal bones follows the arterial pathways through and plantar venous plexuses that collect blood from the and intraosseous systems. The converge into the , which drains medially into the and laterally into the small saphenous vein, facilitating superficial return to the lower limb. Plantar metatarsal veins, accompanying the plantar arteries, form a deep plexus that empties into the , with perforating veins linking the and plantar systems for efficient overall drainage. Regional variations in vascularity emphasize greater density in the metatarsal heads to nourish the adjacent , where and plantar branches form a rich periarticular , particularly at the plantar-lateral neck of the first metatarsal head supplied by the first , first plantar, and medial plantar arteries. Anastomoses between and plantar metatarsal arteries occur via proximal and distal perforating branches in the intermetatarsal spaces, enhancing collateral flow across the forefoot. These patterns provide robust circulation adequate for maintenance and repair, with foramina consistently located in the middle third of the shafts in over 90% of cases.

Neural supply

The neural supply to the metatarsal bones primarily involves branches of the tibial and common fibular (peroneal) nerves, providing both sensory and motor innervation to the bones, surrounding soft tissues, and intrinsic foot muscles. Sensory innervation to the plantar aspects of the metatarsals and the overlying skin is derived from the medial and lateral plantar nerves, which are terminal branches of the , while the dorsal skin over the metatarsals receives supply from the . Motor innervation targets the intrinsic foot muscles that attach to the metatarsals, predominantly via the lateral plantar nerve, which supplies the dorsal and plantar interossei, adductor hallucis, and lumbricals 2–4, enabling fine control of toe flexion and adduction. The medial plantar nerve contributes motor fibers to the abductor hallucis, flexor digitorum brevis, and the first lumbrical, supporting actions at the first metatarsal. Specific sensory distributions vary by metatarsal: the first metatarsal receives primary supply from the medial plantar nerve to its medial and plantar surfaces; the second and third metatarsals share innervation between the medial and lateral plantar nerves for their interdigital and plantar regions; and the fourth and fifth metatarsals are mainly innervated by the lateral plantar nerve laterally, with additional sural nerve contributions to the dorsal lateral aspects. The of the metatarsal bones contains dense fibers, including mechanosensitive endings that detect mechanical distortion, contributing to acute during fractures or . Autonomic components include sympathetic fibers that travel via perivascular plexuses along arteries supplying the metatarsals, regulating tone and blood flow to the bone and surrounding tissues.

Function and biomechanics

Role in weight-bearing and locomotion

The metatarsal bones play a crucial role in by forming the distal aspect of the foot's transverse arch, which helps distribute approximately 50% of the body weight across the forefoot during the stance phase of . The heads of the metatarsals create this arch, with the first and fifth metatarsals functioning as key pillars that provide and support the majority of the load, while the metatarsals (II-IV) contribute to even . This structural arrangement allows the forefoot to adapt to ground contact and maintain balance under vertical loads. During locomotion, the metatarsals facilitate smooth transitions through the gait cycle, particularly via dorsiflexion at the metatarsophalangeal (MTP) joints, which typically ranges from 20 to 50 degrees to accommodate the foot's progression from strike to toe-off. The second metatarsal often experiences the peak pressure in normal walking, reflecting its central position in load transfer during mid-stance and phases. Integration of the transverse arch (formed by metatarsals II-IV) with the longitudinal arches enhances by dissipating impact forces and enables efficient through controlled deformation and . Biomechanically, the metatarsals endure ground reaction forces that can reach up to 1.5 times body weight during the push-off phase, where plantarflexion at the MTP joints generates forward momentum. This underscores the metatarsals' role in energy return and . In evolutionary terms, the robust configuration of metatarsals represents an for bipedal , optimizing and stride efficiency compared to quadrupedal ancestors.

Muscle attachments and dynamics

The metatarsal bones provide critical attachment sites for both extrinsic and intrinsic foot muscles, enabling precise control of movements and overall foot stability during . Extrinsic muscles, which originate proximal to the ankle, insert on the bones of the foot, including metatarsals and phalanges, to transmit forces from the to the forefoot. For instance, the tendons of the flexor hallucis and flexor hallucis brevis pass plantar to the first metatarsal head and insert on the phalanges of the hallux, facilitating flexion of the hallux essential for push-off. Similarly, the extensor digitorum tendons run along the dorsal shafts of the second through fifth metatarsals before inserting on the phalanges of the lateral toes, allowing extension of the lateral toes. Specific extrinsic muscle attachments occur at distinct bony prominences on the metatarsal bases. The peroneus longus tendon inserts on the medial tuberosity of the first metatarsal base, contributing to eversion and stabilization of the medial forefoot, while the peroneus brevis attaches to the lateral tuberosity of the fifth metatarsal base, supporting lateral stability. Additionally, the flexor digiti minimi brevis originates from the base of the fifth metatarsal, aiding in flexion of the fifth toe. Intrinsic muscles, arising within the foot, originate directly from the metatarsal shafts and bases, playing a key role in fine and arch maintenance. The four dorsal interossei muscles originate from the adjacent sides of the metatarsal shafts (first to fifth), inserting on the proximal phalanges to abduct the toes relative to the second toe axis; they attach prominently to the second through fourth metatarsals. The three plantar interossei originate from the medial bases and shafts of the third through fifth metatarsals, inserting on the corresponding proximal phalanges to adduct the toes. The four lumbricals arise from the tendons of the flexor digitorum longus and attach to the medial aspects of the extensor hoods over the first through fifth metatarsal heads, functioning to flex the while extending the interphalangeal joints. During dynamic activities such as walking, these muscle attachments generate coordinated forces that stabilize the metatarsals, particularly during the toe-off phase of . The interossei muscles contract to maintain the transverse arch integrity by countering lateral deviations and supporting the metatarsal heads against ground reaction forces. Tension transmitted across the metatarsal shafts by both extrinsic and intrinsic pulls enhances propulsion efficiency, with balanced muscular action distributing loads to prevent excessive stress on individual bones.

Development and variations

Embryological development

The metatarsal bones originate from the somatic layer of the , which migrates into the lower limb bud to form the mesenchymal core of the developing autopods. The lower limb bud emerges as a small protrusion on the lateral trunk wall around the fourth week of (Carnegie stage 13), opposite the lumbar and sacral myotomes, with the foot plate becoming discernible by the sixth week (stage 17). Within this limb bud , the skeletal precursors of the metatarsals are preformed around the sixth week as condensations in the autopodal , establishing the foundational pattern for the forefoot skeleton. Chondrification of the metatarsal anlagen begins in the (Carnegie stage 18), marking the transition from mesenchymal to cartilaginous models. The process initiates in the central three metatarsals (second, third, and fourth), followed shortly by the first and fifth, within the flattening foot plate where digital rays emerge. This sequential chondrogenesis reflects the proximodistal maturation of the limb, with the metatarsal shafts forming as elongated cartilaginous rods by the end of the (stage 23). The specification of the five distinct metatarsal rays occurs through patterned in the limb bud , primarily driven by (notably Hoxa and Hoxd clusters) and (FGF) signaling pathways. These factors coordinate anterior-posterior identity and ray number, ensuring separation of the metatarsal condensations by intervening that inhibits coalescence and promotes individual bone formation. Proximal-distal outgrowth of the metatarsal precursors is regulated by FGF ligands secreted from the apical ectodermal ridge (AER), a thickened ectodermal structure at the limb bud's distal margin, which maintains mesenchymal proliferation and elongation until the full cartilaginous models are complete by the eighth week.

Anatomical variations and ossification

The metatarsal bones undergo , beginning with primary centers that form in the during the 9th to 10th week of fetal development, with the centers for the second, third, and fourth metatarsals appearing slightly earlier than those of the first and fifth. Secondary centers develop at the proximal epiphyses (bases) postnatally, typically between 15 months and 3 years after birth, with the first metatarsal's center emerging around 3 years and those of the second to fifth around 15 to 18 months; secondary centers also develop at the distal epiphyses (heads) of all metatarsals around the of age, fusing with the shafts by late . These secondary centers fuse with the shafts by , with epiphyseal closure generally completing between 15 and 18 years of age, allowing longitudinal growth along the shafts through the proliferation of chondrocytes in the growth plates. Anatomical variations in metatarsal include differences in relative lengths, classified by metatarsal formulas such as index minus (where the second metatarsal is longer than the first, prevalent in approximately 70% of populations), index plus (first metatarsal longer than the second), and index plus-minus (both equal). These length patterns influence forefoot and load distribution. Accessory , such as the os vesalianum at the base of the fifth metatarsal, occur rarely with a of 0.1% to 5.9%, often arising from unfused secondary centers. Ethnic differences contribute to variations in metatarsal alignment, as populations exhibit distinct medial longitudinal arch heights; for instance, individuals of descent typically have lower arch height indices compared to those of descent, which can alter metatarsal angulation and forefoot . With aging, metatarsal bone mineral density peaks in the third decade of life (around the 20s) and subsequently undergoes resorption after age 50, primarily due to reduced osteoblastic activity and increased function, leading to decreased structural integrity and heightened risk. This age-related decline mirrors broader skeletal changes but is pronounced in weight-bearing foot bones like the metatarsals.

Clinical significance

Injuries and fractures

Metatarsal fractures are among the most common injuries to the foot, accounting for approximately 35% of all foot fractures and up to 5-6% of all skeletal injuries overall. These fractures can result from acute or repetitive , with a higher incidence in athletes, where fifth metatarsal fractures represent up to 25% of foot injuries. In athletes, the risk is elevated due to repetitive loading and high-impact activities, such as running or jumping, making metatarsal fractures a significant concern in . Common fractures include those of the fifth metatarsal, such as the at the base (zone 2, involving the metaphyseal-diaphyseal junction) and tuberosity avulsion fractures (zone 1, at the proximal tuberosity). The typically occurs from inversion of the foot with axial loading on the , while avulsion fractures result from sudden inversion or plantarflexion, pulling on the peroneus brevis or lateral band of the . fractures, often termed "march fractures," predominantly affect the second metatarsal due to its length and rigidity, arising from repetitive microtrauma during prolonged weight-bearing activities like marching or running. A variant of fifth metatarsal injury is the dancer's fracture, a spiral diaphyseal in the distal shaft caused by twisting or rolling over the foot, commonly seen in dancers during plantarflexed positions. Mechanisms of injury vary by metatarsal: direct trauma, such as crush injuries, commonly affects the central metatarsals (second through fourth); inversion sprains lead to fifth metatarsal fractures; and axial loading impacts the first metatarsal, often from hyperextension or falls. In pediatric cases, growth plate involvement may occur, classified using the Salter-Harris system, where type I and II fractures (through or above the ) generally heal well without growth disturbance. For adults, the AO/OTA classification is used, categorizing fractures as extra-articular (type A, e.g., simple transverse or oblique patterns), partial articular (type B), or complete articular (type C), guiding surgical decisions based on displacement and pattern. Acute management focuses on for nondisplaced fractures, typically with a short leg cast or walking boot for 6-8 weeks, allowing in most cases under protected . Displaced or unstable fractures, particularly Jones fractures, may require open reduction and internal fixation to promote alignment and healing. Non-union risk is notably higher in proximal fifth metatarsal fractures (up to 20%), attributed to relatively poor in zone 2, which can delay healing beyond 12 weeks despite conservative treatment.

Deformities and pathologies

Hallux valgus, commonly known as a , is a prevalent forefoot characterized by lateral deviation of the great toe at the first metatarsophalangeal (MTP) joint, often accompanied by medial deviation of the first metatarsal, termed metatarsus primus varus. This condition increases pressure on the second through fifth metatarsal heads, leading to secondary deformities such as hammertoes. It affects approximately 23% of adults aged 18 to 65 years and up to 36% of those older than 65, with a higher in females, estimated at around 30% in women over 50. Biomechanical factors, including prolonged use of high-heeled or narrow , contribute to its development by altering forefoot loading and promoting medial metatarsal drift. Metatarsus adductus involves medial deviation of the metatarsals I through IV relative to the hindfoot at the tarsometatarsal (Lisfranc) , resulting in a curved forefoot appearance. This congenital or flexible deformity is the most common foot anomaly in newborns and typically resolves spontaneously, though rigid cases may persist and affect . Congenital brachymetatarsia presents as shortening of one or more metatarsals due to premature physeal closure, most frequently affecting the fourth metatarsal and leading to a shortened with potential cosmetic and functional concerns. In pes cavus, an elevated medial longitudinal arch results in prominent metatarsal heads on the plantar surface, increasing pressure and risk of calluses or stress under these heads. Freiberg's infraction is an causing of the second metatarsal head, predominantly in adolescents, particularly females during their second decade, and manifests as pain and swelling exacerbated by activity. involves of the sesamoid bones beneath the first metatarsal head, often from repetitive hyperextension or increased plantar pressure, resulting in localized pain at the ball of the foot. In , erosive at the MTP joints leads to bone erosions on the metatarsal heads and subsequent dorsal subluxation or of the proximal phalanges, affecting up to two-thirds of patients with chronic disease and causing significant forefoot deformity. Gouty tophi, deposits of monosodium urate crystals, can form on the shafts of metatarsal bones in chronic tophaceous gout, potentially weakening the bone and predisposing to pathologic fractures, as seen in cases involving the fifth metatarsal.

References

  1. [1]
    Metatarsal bones: Anatomy - Kenhub
    Function. Along with the calcaneus, the metatarsals are involved in supporting the weight of the body. The metatarsus has 5 main points of contact with the ...
  2. [2]
    Metatarsals - Physiopedia
    Together, the metatarsal and tarsal bones help to form the main arches of the foot, which are essential for weight-bearing and walking.Gross Anatomy & Structure · Articulations · Arches of the Foot · Clinical significance
  3. [3]
  4. [4]
    Bones of the Lower Limb – Anatomy & Physiology - UH Pressbooks
    The base of the metatarsal bone is the proximal end of each metatarsal bone. These articulate with the cuboid or cuneiform bones. The base of the fifth ...
  5. [5]
    [PDF] HV chapter 02-Normal Anatomy of the Forefoot - Kent State University
    The 5 metatarsals are weight-bearing bones and provide a foundation for the digits. The phalanges provide the skeletal structure for the digits. Functionally, ...
  6. [6]
    Radiological Biometric Study of Metatarsals and Phalanges - PMC
    The mean lengths of these were; first metatarsal- 56.42±4.41 mm and 50.09±3.06 mm; second metatarsal - 67.61±3.49 mm and 62.46±3.45 mm, in males and females ...(table/fig-1) · Discussion · Radiographic Analysis Of The...
  7. [7]
    Anatomy, Bony Pelvis and Lower Limb: Calf Peroneus Longus Muscle
    Physiologic Variants. The peroneus longus muscle arises from the head and upper lateral side of the fibula and inserts on the base of the first metatarsal, ...Surgical Considerations · Clinical Significance · Review Questions
  8. [8]
    Metatarsal Bone - an overview | ScienceDirect Topics
    The base of the metatarsal bone is wedge-shaped. It articulates proximally with the tarsal bones, and by its sides with the contiguous metatarsal bones. The ...
  9. [9]
    Metatarsals - Hithera
    THE CHARACTERISTICS OF THE INDIVIDUAL METATARSAL BONES. The first metatarsal bone (fig. 495) is the shortest and thickest of the metatarsal bones. The body ...<|control11|><|separator|>
  10. [10]
    Fractures of the Proximal Fifth Metatarsal - AAFP
    May 1, 1999 · The peroneus brevis tendon inserts in a fan-like pattern across the proximal fifth metatarsal. In contrast, the static lateral band of the ...Abstract · Anatomy and Initial Evaluation · Proximal Fifth Metatarsal...
  11. [11]
    The inter- and intra-rater reliability of the Maestro and Barroco ...
    Aug 16, 2018 · In both studies index minus foot type was most prevalent with metatarsal formula 1 < 2 > 3 > 4 > 5. The observed metatarsal length ...
  12. [12]
    Anatomy, Bony Pelvis and Lower Limb: Metatarsal Bones - NCBI - NIH
    May 23, 2023 · The metatarsal bones are an essential structure for the origin and insertion of many muscles of the lower limb and foot and contribute to the proximal half of ...Introduction · Structure and Function · Embryology · Surgical Considerations
  13. [13]
    Lisfranc fracture-dislocations: current management - PMC - NIH
    The Lisfranc joint or tarsometatarsal joint (TMT) is formed by the five metatarsals that articulate with the three cuneiform bones and the cuboid bone. The ...
  14. [14]
    Tarsometatarsal joints: Anatomy and function - Kenhub
    Mar 6, 2024 · The tarsometatarsal joints, also known as Lisfranc joints, are plane synovial joints formed by the articulations between the distal surfaces ...
  15. [15]
    Tarsometatarsal (Lisfranc) joint complex injuries - UpToDate
    Jul 24, 2025 · The so-called "Lisfranc ligament" consists of three distinct ligaments: the dorsal ligament, interosseus ligament, and plantar ligament (figure ...
  16. [16]
    Joints and ligaments of the foot: Anatomy | Kenhub
    The intermetatarsal joints are articulations formed between the metatarsal bones and are stabilized by intermetatarsal interosseus ligaments. These ligaments ...
  17. [17]
    Intermetatarsal joints - e-Anatomy - IMAIOS
    The metatarsal interosseous ligaments consist of strong transverse fibers which connect the rough non-articular portions of the adjacent surfaces.
  18. [18]
    Metatarsophalangeal (MTP) joints: Bones, movements, musc - Kenhub
    The metatarsophalangeal joints (MTP) are synovial joints that connect the metatarsal bones of the foot to the proximal phalanges of the toes.
  19. [19]
    Metatarsophalangeal joint | Radiology Reference Article
    May 19, 2025 · They are condyloid synovial joints which allow for flexion, extension and limited adduction and abduction 2.Missing: type | Show results with:type
  20. [20]
    Deep transverse metatarsal ligament - e-Anatomy - IMAIOS
    The deep transverse metatarsal ligament is a narrow band which runs across and connects together the heads of all the metatarsal bones; it is blended ...
  21. [21]
    Anatomy, Bony Pelvis and Lower Limb: Foot Arteries - NCBI - NIH
    The vasculature of the foot is composed of arteries that originate from the anterior and posterior tibial arteries, the terminal branches of the popliteal ...
  22. [22]
    Blood Supply to the Foot - Foot & Ankle - Orthobullets
    Jun 7, 2021 · The foot's blood supply comes from three primary arteries: the peroneal, posterior tibial, and anterior tibial arteries.
  23. [23]
    Arterial supply to the foot | Radiology Reference Article
    Aug 9, 2024 · The arterial supply to the foot is divided into plantar and dorsal components. The posterior tibial artery gives off the calcaneal branch for ...
  24. [24]
    Blood supply to the first metatarsal head and vessels at ... - PubMed
    The first metatarsal head is supplied by the first dorsal, first plantar, and medial plantar arteries, forming a plexus at the plantar-lateral neck. The ...
  25. [25]
    Entry points of nutrient arteries at risk during osteotomy of the lesser ...
    Aug 8, 2018 · In conclusion, this study has shown that the nutrient arteries supplying the second, third, and fourth metatarsals enter at the middle third ( ...
  26. [26]
    Direction and location of the nutrient artery to the fifth metatarsal at ...
    The nutrient artery entered the medial aspect of the fifth metatarsal around the junction of the middle and proximal thirds obliquely from a distal direction.
  27. [27]
    Location and direction of the nutrient artery to the first metatarsal at ...
    We investigated the first metatarsal nutrient artery, arising from the first dorsal metatarsal artery, and identified aspects of surgical technique contributing ...
  28. [28]
    Venous drainage of the foot | Radiology Reference Article
    Sep 20, 2020 · Venous drainage of the foot can be divided into two main components. Plantar veins, draining the sole (plantar surface) of the foot, and the dorsal veins.
  29. [29]
    Diaphysial nutrient foramina in human metacarpals and metatarsals
    It was found that, in general, these bones had one nutrient foramen which was situated in the middle third of the shaft (over 90%). Few bones had no foramina ...
  30. [30]
    Anatomy, Bony Pelvis and Lower Limb, Foot Nerves - NCBI - NIH
    The foot receives its nerve supply from the superficial peroneal (fibular) nerve, deep fibular nerve, tibial nerve (and its branches), sural nerve, and ...
  31. [31]
    Medial Plantar Nerve - Course - Motor - Sensory - TeachMeAnatomy
    The medial plantar nerve is a branch of the tibial nerve in the foot. It supplies motor innervation to the plantar foot muscles and cutaneous sensation.
  32. [32]
    Lateral Plantar Nerve - Course - Supply - TeachMeAnatomy
    The lateral plantar nerve is a branch of the tibial nerve in the foot. It supplies motor innervation to the plantar foot muscles and cutaneous sensation.
  33. [33]
    Nerves of the Foot - Foot & Ankle - Orthobullets
    Jul 11, 2021 · Branches of the Tibial nerve: Medial calcaneal nerve innervates plantar medial heel, Medial plantar nerve innervates at risk proper branch of medial plantar ...
  34. [34]
    Lateral Plantar Nerve - Physiopedia
    The nerve divides into two branches: medial and lateral. It provides motor and sensory innervation to the foot muscles. Medial plantar nerve Motor fibres ...
  35. [35]
    Anatomy, Bony Pelvis and Lower Limb, Foot Muscles - NCBI - NIH
    Apr 8, 2023 · There are 29 muscles associated with the human foot: 10 originate outside the foot but cross the ankle joint to act on the foot, and 19 are intrinsic foot ...Introduction · Structure and Function · Blood Supply and Lymphatics · Nerves
  36. [36]
    Medial plantar nerve: Course and distribution | Kenhub
    May 20, 2024 · The cutaneous distribution is to the anterior two-thirds of the medial sole and medial three and one-half digits, including the nail beds. A ...
  37. [37]
    Lateral plantar nerve | Radiology Reference Article - Radiopaedia.org
    Apr 14, 2023 · The lateral plantar nerve is an important motor nerve in the foot as it innervates all the intrinsic muscles in the sole.
  38. [38]
    New Insights in Understanding and Treating Bone Fracture Pain
    Many of these mechanosensitive nerve fibers that detect and signal the initial fracture pain are located in the periosteum which is tightly opposed to the ...
  39. [39]
    The Physiology of Bone Pain. How Much Do We Really Know?
    Clinical and experimental observations suggest that bone pain can be derived from noxious stimulation of the periosteum or bone marrow.Missing: foot | Show results with:foot
  40. [40]
    The sympathetic innervation of the human foot - PubMed
    It is concluded that (1) sympathetic innervation of the foot arrives along each peripheral nerve, (2) the vessels already contain sympathetic innervation at ...Missing: perivascular plexuses
  41. [41]
    Innervation of Periosteum and Bone by Sympathetic Vasoactive ...
    Immunohistochemical studies demonstrated a system of vasoactive intestinal peptide (VIP)-immunoreactive nerve fibers that innervate periosteum and bone in ...
  42. [42]
    Metatarsal Loading During Gait-A Musculoskeletal Analysis
    Aug 6, 2025 · The metatarsal heads bear approximately 50% of the body weight in the final stage of forefoot contact with the ground during walking [2]. In the ...
  43. [43]
    [PDF] First Metatarsophalangeal Joint During Gait
    There has been similar variability in the reported measurements of mo- tion of the first metatarsophalangeal joint during gait, with values ranging between 50 ...<|control11|><|separator|>
  44. [44]
    Plantar Pressure Classification & Feature Extraction
    Apr 17, 2025 · Measuring peak plantar pressure during walking ... walking, the forefoot primarily bears load between the second and third metatarsals.
  45. [45]
    Arches of the foot: Anatomy | Kenhub
    The anterior pillar consists of the fourth and fifth metatarsal heads whilst the calcaneus forms the posterior pillar. The main contributor to stabilisation of ...
  46. [46]
    Ground reaction forces at different speeds of human walking and ...
    The peak amplitude of the vertical reaction force in walking and running increased with speed from approximately 1.0 to 1.5 b.w. and 2.0 to 2.9 b.w. ...
  47. [47]
    The functional importance of human foot muscles for bipedal ... - PNAS
    Jan 17, 2019 · The long arch of the human foot is highly evolved to both suit elastic absorption of energy and provide a stiff foot to push against the ground.
  48. [48]
    Muscles of the Foot - Dorsal - Plantar - TeachMeAnatomy
    They are innervated by the medial or lateral plantar nerves – which are branches of the tibial nerve.
  49. [49]
    Base of metatarsal bone - e-Anatomy - IMAIOS
    The 1st metatarsal bone's base provides attachment to the tibialis anterior muscle's tendon on its medial side. Lateral compartment leg muscles include peroneus ...
  50. [50]
    Metatarsal Loading During Gait-A Musculoskeletal Analysis - PubMed
    The objective of this study was to use a detailed musculoskeletal model to compute the loads applied to the metatarsal bones during gait across several healthy ...
  51. [51]
    Lateral Plate Mesoderm - Developmental Biology - NCBI Bookshelf
    On either side of the intermediate mesoderm resides the lateral plate mesoderm. Each plate splits horizontally into the dorsal somatic (parietal) mesoderm, ...
  52. [52]
    Development of the Foot and Ankle - Musculoskeletal Key
    May 28, 2016 · From the sixth to the ninth month, the metatarsal formula is 2>1>3>4>5 or the occasional variant 2>3>1>4>5.
  53. [53]
    The roles of FGFs in the early development of vertebrate limbs
    Several lines of evidence suggest that FGF genes, particularlyFgf8 and Fgf10, play a role in mediating the initial outgrowth of the limb and in establishing the ...
  54. [54]
    Hox genes in development and beyond
    Jan 16, 2023 · Hox genes encode evolutionarily conserved transcription factors that are essential for the proper development of bilaterian organisms.
  55. [55]
    Understanding the Cellular and Molecular Mechanisms That Control ...
    Oct 11, 2019 · The outgrowth of the limb bud is coordinated by the apical ectodermal ridge (AER), positioned at the distal part of the limb at the boundary ...
  56. [56]
    [PDF] Pattern of Major Sites of Ossification in Foetal Hand and Foot Bones
    Materials and Methods: The onset of main ossification centers in hand and foot bones was examined in 48 foetuses between 8 weeks and 9 months gestational age.
  57. [57]
    [PDF] Metatarsal Bones - Thieme Connect
    Each metaphyseal shaft has a primary ossification center that appears during the third month of fetal development. The epiphyseal centers of the metatarsal ...
  58. [58]
    Template:Lower limb ossification table - UNSW Embryology
    The centre for the 2d metatarsal usually appears first, then come the 3rd, 4th, 1st and 5th. The epiphysis of the 1st metatarsal appears at the proximal end of ...
  59. [59]
    [PDF] evaluation of metatarsal relationships in the biomechanics of 332 ...
    The mean normal pattern for males and females respectively was the following: metatarsus I 2.4 mm and 2.2 mm shorter than metatarsus II; metatarsus III. 4.4 mm ...
  60. [60]
    The Prevalence of Accessory Ossicles, Sesamoid Bones, and ... - NIH
    It is a very rare accessory bone, with 0.1% to 5.9% prevalence (Table 2). The os vesalianum is mostly asymptomatic, but it may sometimes cause lateral foot pain ...
  61. [61]
    Comparison across race, gender, arch flexibility, and foot types - NIH
    When comparing across race, Black participants showed a significantly lower arch height index (AHI), a larger malleolar valgus index (MVI), and a higher ...
  62. [62]
    Effects of age, density, and geometry on the bending strength of ...
    These results indicate that the strength of human metatarsals generally decreases with age and that this decrease is likely attributable to decreased bone ...
  63. [63]
    Rate of tarsal and metatarsal bone mineral density change in adults ...
    Feb 13, 2023 · Our study identified that mean BMD (mg/cm3) and calcaneal BMD (mg/cm3) are lower in older individuals, and the rate of BMD loss is more rapid ...
  64. [64]
    Metatarsal Fractures - Nana O. Sarpong, Hasani W. Swindell, Evan ...
    Aug 10, 2018 · Metatarsal fractures account for a significant proportion of foot injuries, representing 35% of all foot fractures and 5% to 6% of all skeletal injuries.
  65. [65]
    An overview of the risk factors for producing fifth metatarsal fracture ...
    In recent studies, fracture of the fifth metatarsal accounts for 10% of all sports injuries and 25% of foot injuries, with a higher incidence in men than in ...<|control11|><|separator|>
  66. [66]
    Metatarsal Stress Fractures in the Athletic Population - Physiopedia
    The second and third metatarsals are most at risk during ballet in the en pointe position due to the locking of the second metatarsal base and cuneiforms in ...<|separator|>
  67. [67]
    5th Metatarsal Base Fracture - Foot & Ankle - Orthobullets
    Oct 19, 2025 · 5th Metatarsal Base Fractures are among the most common fractures of the foot and are predisposed to poor healing due to the limited blood ...
  68. [68]
    5th Metatarsal Fracture - StatPearls - NCBI Bookshelf
    Metaphyseal arteries and diaphyseal nutrient arteries provide the blood supply to the fifth metatarsal base. A vascular watershed area exists in zone 2 ...<|separator|>
  69. [69]
    March fracture | Radiology Reference Article - Radiopaedia.org
    Sep 11, 2025 · March fractures are a subtype of fatigue/stress fractures. They occur due to repeated concentrated trauma to a normal bone, classically the 2nd ...Missing: second | Show results with:second<|separator|>
  70. [70]
    Metatarsal Fractures - Physiopedia
    The most common mechanism of injury in fifth metatarsal fractures involves a fall from standing height or an ankle twist with the forefoot fixed.
  71. [71]
    Metatarsal Foot Fractures - Emergency Department
    Metatarsal fractures are common in the paediatric population and rarely require operative management. ... Common mechanisms of injury include: Fall from a ...
  72. [72]
    Metatarsal fractures - AO Surgery Reference
    These fractures are classified by the AO/OTA as 87. 1–4 .3A fractures, and they may be simple or multifragmentary. Learn moreChoose fracture ...Proximal avulsion fractures of... · Diaphyseal fractures of the 5th... · All approaches
  73. [73]
    Diagnosis and Management of Metatarsal Fractures - AAFP
    Sep 15, 2007 · Nondisplaced fractures of the metatarsal shaft usually require only a soft dressing followed by a firm, supportive shoe and progressive weight bearing.
  74. [74]
    5th Metatarsal Fracture Surgery Procedure & Recovery - FootCareMD
    Most Zone 2 breaks will go on to heal after 12 weeks with appropriate treatment. The nonunion rate for these fractures may still be as high as 15-20%. A ...What Is Fifth Metatarsal... · Diagnosis · Treatments
  75. [75]
    Hallux Valgus - StatPearls - NCBI Bookshelf
    Hallux valgus (HV), also known as a bunion, is one of the most common forefoot deformities ... Increased pressure on second through fifth metatarsal bones.Introduction · History and Physical · Evaluation · Treatment / Management
  76. [76]
    Knowledge, Attitude, and Practice Toward Hallux Valgus Among ...
    Aug 8, 2025 · A crucial external factor contributing to hallux valgus development is footwear choice, notably narrow shoes with high heels. Women's ...
  77. [77]
    Metatarsus Adductus - Physiopedia
    It is an adduction deformity or medial deviation of the forefoot at the tarsometatarsal joints (Lisfranc joint) with respect to the hindfoot.
  78. [78]
    Metatarsus Adductus - Pediatrics - Orthobullets
    Jun 14, 2021 · Treatment is generally nonoperative with stretching if the deformity can be passively corrected, and with casting if the deformity is rigid.
  79. [79]
    Brachymetatarsia - Pediatrics - Orthobullets
    Jun 15, 2021 · Brachymetatarsia is a rare congenital condition caused by premature epiphyseal closure of the metatarsals that presents with shortening of one ...
  80. [80]
    Pes Cavus - Physiopedia
    This type of disorder causes the foot to prone to metatarsal head and calcaneal contusions, caused by the excessive pressure of weight bearing. Also the foot is ...
  81. [81]
    Freiberg Infraction - StatPearls - NCBI Bookshelf
    Freiberg disease is an uncommon yet clinically significant condition characterized by osteonecrosis of the metatarsal heads, prominently the second metatarsal.Continuing Education Activity · Introduction · Evaluation · Treatment / Management
  82. [82]
    Sesamoiditis - Physiopedia
    Often localized to the first metatarsal head.Next most frequent site of metatarsal head pain is under the second metatarsal.[5][9][10] Factors that can ...
  83. [83]
    Rheumatoid forefoot deformity: pathophysiology, evaluation and ...
    It is estimated that with chronic polyarthritis two thirds of patients will develop subluxation and dislocation of the lesser MTP joints. The incidence and ...
  84. [84]
    Spontaneous Fracture of the Fifth Metatarsal Secondary to Gout ...
    Jun 14, 2023 · Spontaneous fractures caused by gouty tophi are rare and difficult to diagnose, especially if the context of gout is not known, as in our case. ...