The metatarsal bones are a group of five long bones located in the metatarsus of the foot, between the tarsal bones (near the ankle) and the phalanges (toe bones). These bones are numbered from one to five, starting with the first metatarsal beneath the big toe and moving laterally towards the fifth metatarsal beneath the little toe.
Each metatarsal bone has three distinct parts: a proximal base that articulates with the tarsal bones, a slender shaft in the middle, and a distal head that connects to the proximal phalanges of the toes.
The metatarsals play a vital role in forming the arches of the foot, that are essential for weight bearing, balance, and walking.
|Five long bones (I to V) in the foot, between the tarsal bones and the phalanges.
|Tarsometatarsal, metatarsophalangeal, and intermetatarsal joint
|Support body weight, help form foot arches, and facilitate balance and walking
- Clinical notes
The first metatarsal is the thickest and shortest of the metatarsals. At the base there are normally no facets but sometimes there is a facet laterally, where it articulates with the second metatarsal. Proximally, it articulates with the medial cuneiform at the base. Here, there is a tuberosity medially. The shaft is strong and a prismoid shape. Distally, there are two grooved facets where the two (hallucal) sesamoid bones articulate on the plantar surface. The hallucal sesamoids are always present at the plantar aspect of the first metatarsal head, and are a constant in humans. The shaft articulates distally with the 1st proximal phalanx.
The muscle attachments of the first metatarsal are the following:
The second metatarsal is the longest of the metatarsals and has four articular facets at its base. These articulate with the medial, intermediate and lateral cuneiforms as well as the third metatarsal. Occasionally there is a medial facet at the base, which articulates with the first metatarsal. Distally, it articulates with the 2nd proximal phalanx.
The muscle attachments of the second metatarsal are the following:
- Medial shaft – 1st dorsal interosseus muscle
- Lateral shaft – 2nd dorsal interosseus muscle
The third metatarsal has a triangular base, which articulates proximally with the lateral cuneiform. Medially it has two facets where it articulates with the second metatarsal and laterally it articulates with the fourth metatarsal by a single facet. The head articulates with the 3rd proximal phalanx.
The muscle attachments of the third metatarsal are the following:
- Medial shaft – 2nd dorsal interosseus and 1st plantar interosseus muscles
- Lateral shaft – 3rd dorsal interosseus muscle
The fourth metatarsal is smaller than the third and has 3 articular facets at its base. Proximally, it has a quadrilateral facet, which articulates with the cuboid. There is an oval facet medially which articulates with the third metatarsal and there is another single facet on the lateral surface for articulation of the fifth metatarsal. Distally, the head articulates with the 4th proximal phalanx.
The muscle attachments of the fourth metatarsal are the following:
- Medial shaft – 3rd dorsal interosseus and 2nd plantar interosseus muscles
- Lateral shaft – 4th dorsal interosseus muscle
The fifth metatarsal has a tuberosity lateral to the base, which can be both seen and felt on the lateral border of the foot. The base articulates with the cuboid proximally by a triangular surface and medially with the fourth metatarsal. Its head also articulates with the 5th proximal phalanx.
The muscle attachments of the fifth metatarsal are the following:
The metatarsals connect the ankle with the toes. They are named I to V from medially to laterally, looking at the dorsal surface of the foot. The metatarsal bones are convex on their dorsal surfaces but concave on their plantar surfaces. The proximal base articulates with one or more of the distal tarsal bones; namely the cuboid and the cuneiform bones. These articulations are known as the tarsometatarsal joints.
The distal heads articulate with their corresponding proximal phalanx to form the metatarsophalangeal joints. The head of the first metatarsal also articulates with two sesamoid bones on the plantar surface of the foot.
In addition, the bases of the metatarsals articulate with each other to form intermetatarsal joints. The smooth areas on the metatarsals that articulate with other bones are known as articular facets.
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 ground:
- The head of 1st metatarsal and two sesamoid bones
- The head of 2nd metatarsal
- The head of 3rd metatarsal
- The head of 4th metatarsal
- The head of 5th metatarsal
The majority of the load is supported by the thicker 1st metatarsal, with the 2nd-5th metatarsals providing balance and comfort.
Test your knowledge on the bones of the foot with our interactive quiz.
Fractures of the metatarsals are uncommon but occur when a heavy object falls or rolls over the foot. These fractures can also occur in ballet dancers when they lose balance whilst on the tips of their toes. This results in the metatarsals supporting the whole body weight, which may cause a fracture of one or more of the metatarsals.
Gout is an inflammatory arthritis characterised by high levels of uric acid in the blood and crystal deposits in the joints and surrounding tissues. The metatarsophalangeal joint of the great toe is often the first joint affected by gout. Gout can cause tenderness and oedema in this joint. When this joint is affected, it is referred to as podagra. Osteoarthritis can also cause severe pain in this joint.
Hallux valgus is a foot deformity characterised by medial deviation of the 1st metatarsal and deviation of the great toe (hallux) laterally. It is often caused by degenerative joint disease or by pressure from footwear. More commonly occurring in females, hallux valgus causes the 1st metatarsal to shift medially and the sesamoid bones to shift laterally. This results in the sesamoid bones lying between the heads of the 1st and 2nd metatarsals. When the surrounding tissues swell, a subcutaneous bursa can form. When this bursa is inflamed this can cause great pain. A painful hallux valgus deformity is referred to as a bunion.
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